ing Rules 
ealthy Infants 




(lass K.T2P>f> 

Book H 13. 

Copyright If 



COPYRIGHT DEPOSIT. 



FEEDING RULES 

FOR 

Healthy Infants 



BY 

CHARLES DOUGLAS, M. D. 

Protestor of Children's Diseases and Clinical Medicine, Detroit College of Medicine; 

Consulting Physician to Harper Hospital; Senior Physician to the Protestant 

Orphan Asylum; Member of the Ohio State Pediatric Society; 

American Medical Association, and Michigan 

State Medical Society. 



CONTAINING EDUCATIONAL AND RECORD CHARTS 

SHOWING PRACTICAL PERCENTAGE FEEDING 

WITHOUT LABORATORY ASSISTANCE 



BABY BOOK CO., Publishers 

DETROIT, MICH. 
1906 



LIBRARY of CONGRESS 

Two Copies Received 

NOV 20 1905 

^-Cooyrleht Entry 

Julu8,t<)cr 

CLASS J A XXc, No, 

copy 'er 



Copyright, 1905 
By CHARLES DOUGLAS. M. D. 






^ 



THIS BOOK IS RESPECTFULLY 

DEDICATED 

TO THE MANY MOTHERS AND NURSES WHO FAITHFULLY AND 
INTELLIGENTLY FILLED ENOUGH OF THE AUTHOR'S EDUCA- 
TIONAL FEEDING CHARTS TO FURNISH OVER FIFTEEN 
THOUSAND DAILY RECORDS OF FOODS GIVEN THEIR 
INFANTS AND ALSO THE RESULTS PRODUCED BY 
THEM. FROM THIS PRACTICAL INFORMA- 
TION, IT HAS BEEN POSSIBLE TO CON- 
STRUCT VERY MANY OF THE 
FOLLOWING PAGES. 



PREFACE 



Many valuable books have been written during the past 
ten years on the nutrition and proper feeding of infants. 
From these books, the writer has received valuable assist- 
ance in pursuing this branch of pediatrical work. 

In doing practical infantile feeding, without the assist- 
ance of a Walker-Gordon milk laboratory, the author found 
it necessary to devise a chart which would be a perfect 
record of the foods and amounts used daily and one which 
would also show the exact effects they produced. Use and 
necessity gradually added important features. These were 
mainly evolved by the demands of memory when treating 
many cases, and by the necessity to teach mothers and 
nurses to concentrate their thoughts and attention on all 
those features necessary for successful work. 

Daily filling of these charts by mothers or nurses made 
them acutely and intelligently interested in doing careful 
and exact work. Their thoughts were concentrated on the 
essentials, and daily filling of each item reminded them of 
everything needed, thus preventing errors of omission. 

This work demanded that the food must be prepared in 
the way most familiar to them, and, consequently, the old 
way of raising the cream and then removing it from the 
skim-milk was adopted. Mothers very easily learned to 
mix these together in the proportions necessary to suit their 
infants; to dilute them with water and then sweeten the 
whole mixture. 

7 



8 PREFACE 

This is the method followed in the Walker-Gordon labo- 
ratories, when physicians write prescriptions ordering the 
required proportions of fat (cream), proteids (skim-milk) 
and sugar for any infant. 

As only a very few rich people can ever feed their infants 
from laboratories, it was necessary to adopt a plan which 
could be used by all mothers and one which could educate 
them to change the food themselves when necessary. 

On account of its simplicity and suitability to mothers, 
all foods are designated by ounces, tablespoons and tea- 
spoons, and no effort is made to express them by percent- 
ages of fat, proteids or sugar. 

Over fifteen thousand daily records of foods given, and 
their results were obtained in this manner, and from this 
material as well as from very many unwritten records also, 
most of the results in the following pages have been ob- 
tained. The milk was all kinds that were reasonably pure 
and clean. 

In the following pages appear some things differing from 
what is generally understood on some points, and also a 
few things that are entirely new. These differences and 
everything that is new are the combined product of these 
charts filled by many mothers unacquainted with each other, 
and working with different milks in their own homes, on all 
kinds of infants and at all ages under two years. Their 
work shows a striking unanimity in results and unmistak- 
ably defines many facts which could not be proven in any 
other way. These charts have been a welcome experience 
and education to the writer. 

Chas. Douglas. 
959 Jefferson Avenue, Detroit, Mich. 



THE LENDING AND BORROWING 
OF BOOKS 



Contagious diseases are the most frequent cause of sick- 
ness in childhood. Aside from digestive disturbances, chil- 
dren are most amenable to contagion in its many forms. 
Such diseases as dyphtheria, scarlet fever, measles, whoop- 
ing-cough, mumps, chicken-pox, etc., are mostly confined to 
this period of life. These contagions are conveyed by all 
objects and persons exposed to them, and many thousands 
of children are sickened and die in this way every year. 
Thorough disinfections will destroy these contagions in 
clothes and all utensils, but no means have ever been found 
by which books can be disinfected and the contagious poi- 
son eliminated from the leaves w T here it will live for many 
months, and some claim even longer. 

All books on infantile subjects thus become saturated 
with contagions and are a great source of danger after- 
wards. 

The mother who lends such books is often the innocent 
means of sickening her friend's children. 

The mother who borrows them runs a great risk of also 
borrowing some serious contagion. These books are safe 
only in the house where they are owned. 



CONTENTS 



CHAPTER I 

PAGE 

Introductory 13 

1, Children of Habit ; 6, Perfect Nutrition ; 20, A Mother's 
Responsibility ; 24, The Worried and Abused Mother. 

CHAPTER II 

Varieties of Human Milk 25 

31, Human Milk; 35, Injurious Human Milk; 41, Irritating 
but Good Human Milk; 44, Nursing Mothers ; 48, Insufficient 
Human Milk; 49, Poor Human Milk; 50, Food of the Mother; 
55, Drinking Milk to Make Milk; 57, Mothers Taking Medicine 
while Nursing. 

CHAPTER III 

Condition of the Nursing Mother 37 

C3, Nursing Sore Breasts ; 65, Sore Nipples ; 70, Treating 
Sore Nipples ; 77, The Nipple Shield ; 78, The Breast-pump. 

CHAPTER IV 

Nursing Infants 43 

79, Nursing Infants ; 83, Regularity in Nursing ; 84, Length 
of Time for Nursing; 86, Overfeeding Nursing Infants; 87, 
Nursing Infants Requiring Additional Food ; 89, Imperfect 
Nursing which Demands Hand-feeding ; 106, Sudden Weaning. 

CHAPTER V 

Cow's Milk Foods 55 

107, Selecting Milk for the Baby; 113, Cow's Milk; 118, How 
to Separate Cream from Milk; 127, Whole Milk vs. Skim-milk; 
130, Varying Amounts of Cream in Milk ; 132, Variations in 
the Strength of Milk; 140, Milk as a Drink; 144, Souring of 
Milk ; 145, Pasteurization of Milk ; 148, Sterilization of Milk ; 
150, Peptonization of Milk; 157, Condensed Milk; 161, Evapor- 
ated Cream. 

11 



12 CONTENTS 

CHAPTER VI 

Substitute Foods and Feeding 76 

164, Artificial or Hand-feeding ; 168, Women Suitable to do 
Hand-feeding; 174, Ignorance and Inexperience; 177, The 
Importance of Proper Diet during the First Year; 186 ; Dangers 
of Imperfect Hand-feeding ; 189, Foods and their Sources ; 198, 
Human Milk as an Assistant to Hand-feeding ; 202, Preparation 
of the Infant's Food ; 210, Food Effects and their Substitutes ; 
219, The Hungry Child ; 224, Frequency of Meals ; 231, Increases 
of Foods ; 247, General Principles Governing Necessary Changes 
in Food; 255, When and How to Change the Baby's Food; 268, 
Feeding the Damaged Infant; 276, Feeding in Hot Weather; 
281, Care of the Food in the Summer-time; 284, Amount of 
Food and Size of Baby ; 290, Foods Required in the Infant's 
Meals ; 297, Top-milk ; 302, Starch ; 303, When to Commence 
and How to Feed Starch ; 306, Starch in its Relation to Sugar ; 
307, Feeding Starches and Effects Therefrom ; 312, Salt in Gruel 
or Milk Foods ; 313, Potato as an Infantile Food ; 315, Gluten ; 
319, Proprietary Foods; 324, Selecting Starch for the Infant; 
329, Table of Starohes and How to Cook Them; 333, Sour 
Stomach ; 336, Giving Water to the Baby; 339, Giving Laxatives 
to Infants ; 340, Teething ; 343, Hiccup or Hiccough ; 344, Cries 
of Infants ; 356, Washing the Baby's Mouth ; 359, Nipples ; 363, 
Bottles. 

CHAPTER VII 
The Feeding Chart 144 

370, The Feeding Chart; 522, Directions for Using the Feed- 
ing Chart; 555, Record Chart. 

CHAPTER VIII 

Food Schedules 199 

558, Milk in the Schedules ; 573, Feeding Schedules ; 580, 
Infants who do not Grow ; 581, Advantages of Dry Foods ; 584, 
Filled Charts. 

CHAPTER IX 

Summary 240 

589, Feeding Rules ; 594, Practical Feeding ; 683, Facts to be 
Remembered. 

CHAPTER X 

Diet for Second and Third Years 268 

735, Feeding during the Second and Third Years ; 775, For- 
bidden Articles of Food ; 782, Food Formulas, 



CHAPTER I 
INTRODUCTORY 

1. We are all children of habit in this world and a 
great many of our habits, thoughts, customs and even our 
politics we inherit from our ancestors. If we critically 
examine ourselves on these different points, we will, in most 
instances, find that we are saying, doing and thinking so 
because we learned to do this while we were yet young and 
inexperienced and because our parents did or said the same 
thing. In this way, the errors of our ancestors were ob- 
tained from their ancestors, and again by these from their 
ancestors for ages back and finally have been handed down 
to us in this twentieth century. 

2. There is only a very limited portion of humanity who 
have critically analyzed the habits and thoughts of their 
ancestors save where they have been compelled to do so 
during their educational courses in schools, colleges and 
universities. 

3. In these institutions, again, our thoughts are shaped 
by those older than ourselves, and, in most cases, we accept 
their doctrines and teachings without giving that crucial 
analysis which only the matured and experienced mind of 
the adult enables one to do. 

4. It is much easier to learn a new subject aright than 
to unlearn an old established one, even though it be wrong. 
Very few of us have the ability, training, strength of mind, 
independence of thought and particularly the facilities to 
unlearn the old errors which have become a part of our 
nature and which we have practised or followed, as abso- 

13 



14 FEEDING RULES FOR INFANTS 

lutely correct, for many years. It is not that educated 
humanity does not desire to make these corrections, but 
because they have not the opportunities and facilities neces- 
sary to accomplish such a result. 

5. In this way, we continue to feed and clothe our in- 
fants, in most instances, according to those ancestral rules 
followed for ages back, without analyzing them carefully 
to ascertain whether they are right or wrong. 

PERFECT NUTRITION 

6. The perfect nutrition of our infants and children, as 
well as that of all humanity, is entirely dependent upon a 
knowledge of the proper foods for each individual to con- 
sume, the proper amounts of each food to be consumed and 
those evidences which show that digestion is perfectly per- 
formed. 

7. There is no department of our educational system 
which gives to either infants or adults an opportunity to 
learn this vital and all-important subject; nor is there an 
educational system in any other government in the world, 
so far as the writer knows, which affords more opportuni- 
ties to learn this than does our American system. Just as 
Americans have made advances in many other lines — scien- 
tific, economical and financial — beyond that point reached 
by many nations, so does it behoove us' to continue in our 
efforts of advancement in all lines where it is apparent that 
improvement is very necessary. 

8. It is needless to dwell upon the great difficulties under 
which the delicate, weak or crippled labor in this life. We 
have too many illustrations of this continually before our 
eyes in all communities and in all parts of our country. If 
our parents were so educated that they could trace appar- 



PERFECT NUTRITION 15 

ent weaknesses back to their origin as clearly and distinctly 
as can the intelligent physician, there would be such an awak- 
ening of the public on these matters as would compel all our 
educational systems to thoroughly implant and teach the 
perfect nutrition of humanity as the first and most import- 
ant subject necessary for successful advances in all branches 
pf education, whether they be in the preparatory work of our 
youths or in the whole life work of our citizens at large. 
To all thoughtful, progressive, scientific and experienced 
physicians, there is no subject of so grave and great impor- 
tance as this perfect nutrition of the human being (179). 

9. The time will come, as it must, when humanity will 
fully realize that the only sure and safe foundation, upon 
which rests the future success of both children and adults, 
is the perfect nutrition of all parts of their bodies. We all 
know that sick men or women, confined to their beds, are 
unable to make any physical or mental efforts except in a 
very limited degree. Between this degree of weakness and 
that of the perfectly healthy condition, every evidence of in- 
ability to perform a full proportion of labor is recognized 
when due to physical inability; but when it comes to that 
mental strength necessary for the performance of regular 
duties, humanity does not recognize or see that there must 
be the same incapacity in this that they see in the physical 
condition, and the consequence is that distressing results and 
failures are continually presented by people whose nutri- 
tion is not such as is and should be demanded for every 
person doing heavy mental labor. 

10. The American habit of demanding extraordinary 
business, professional, scientific, and other forms of mental 
labor, while we notoriously neglect our meals and the quality 
of the food which we consume, is very common. We are 



16 FEEDING RULES FOR INFANTS 

continually filling all the different walks of life with fail- 
ures which could have been and will be avoided when 
proper nutrition of the body and mind are thoroughly 
understood and this subject given the first consideration as 
the foundation of future success. 

11. The day will come, in America, and in other coun- 
tries also, when the principles of human nutrition are taught 
to the rising generation just as are now taught in our agri- 
cultural colleges the different kinds of soils and fertilizers 
suitable for growing and nourishing grain, flowers, shrubs, 
and trees, and also the various kinds of food needed for 
growing and nourishing different animals to the highest 
state of perfection, whether they are required for the pur- 
pose of labor or for the meat-market. Does it not seem an 
awful reflection upon Americans, as a progressive nation, 
that all subjects concerning animals and articles which we 
convert into money, we thoroughly understand and teach, 
but at the same time, neglect to give our rising population 
the advantages of knowing and understanding themselves 
as well as they do all animals and products of the soil ? 

12. It would seem as if we could not, or would not, look 
farther into this subject than that distance which has a 
visible gold or silver lining; in other words, we have paid 
close attention to all things needed for accumulating the 
money required in procuring those things necessary for our 
sustenance and support and fail entirely to reach that point 
which demands a perfect knowledge of how to use this 
accumulation to accomplish our own proper support and 
nourishment and also that of our children. 

13. Would it not seem a natural sequence that, having 
learned how to produce properly and successfully all things 
needed for the nourishment of humanity, we would most 



PERFECT NUTRITION 17 

certainly learn to use them to our greatest advantage, both 
mentally and physically? Yet, such is the unfortunate posi- 
tion which we intelligent, civilized citizens of this twentieth 
century occupy. Statistics from all over the country show 
that we contentedly look on and are satisfied to see thous- 
ands upon thousands of our children sicken, fade away and 
die simply because they are improperly fed, and very many 
more thousands barely escape death itself, through long and 
continued sickness, to grow up permanently maimed, crip- 
pled or debilitated through damages produced directly upon 
the digestive organs, or indirectly on other parts of the body 
which are dependent upon the healthy condition of the 
digestive tract. 

14. We see mental and physical wrecks at all stages and 
in all walks of life, but we are not well enough educated as 
a people to analyze these results and trace them back to 
their origin. 

15. We see a thin, pale girl suffering from headache, 
nervousness and loss of sleep, but we do not recognize that 
these symptoms are merely the result of her imperfect diet- 
ary, her too great confinement to the house and the lack 
of fresh air while she is trying to study her school lessons. 

We see the badly shaped boy with head too large and 
altogether out of shape, but we do not recognize that, had 
he been fed properly when an infant, his head would not 
be of this uncouth form and size. 

We see that other boy with bow legs, an object of fun 
for his class-mates, but we fail to recognize that errors in 
his food, while he was yet a child a year old, gave his legs 
this ungainly shape. 

We see that other boy or man whose knees are contin- 
ually in collision with each other as he walks about the 

2 



18 FEEDING RULES FOR INFANTS 

streets and whose efforts in running have always been the 
cause of laughter for those who saw him, but we do not know 
that his legs were born straight and merely became crooked 
because his mother did not know how to feed him cor- 
rectly. That mother has always wished that he were a girl, 
so that his skirts would hide his deformity. 

In like manner, we can travel through imperfect teeth, 
badly shaped mouth, muddy complexion, frequent convul- 
sions, diarrhea, dysentery and many other disturbances 
which an intelligent physician knows are found nearly 
always in children who are improperly fed and whose nutri- 
tion is consequently poor, thus making them susceptible to 
these disturbances. 

16. Does not all this seem a sad commentary upon our 
boasted intelligence and our vanity? But we are no worse 
than the rest of the world. Is it not time that we awake as 
a nation to the realization of our ignorance and weakness 
on this vital point and make a proper effort to infuse that 
intelligence and knowledge into ourselves, and especially 
into our children, which will enable them in days to come 
to escape either from the grave, from debility, or from that 
weakened condition of both mind and body from which so 
many of us suffer at the present day? 

17. This will be accomplished gradually just as soon as 
our young mothers, who have been taught everything else 
necessary in this life for their benefit and success, realize 
that they have the opportunity and must learn this also, 
for the benefit and advantage of their children. 

18. The following pages will be devoted to showing 
what are the different foods necessary for perfect nutrition 
at different ages and a simple and reliable method of rec- 
ognizing their correct as well as injurious effects upon the 



A MOTHER'S RESPONSIBILITY 19 

human body. By this means, they can regulate the dietary 
of infants and children so as to secure that perfect nutri- 
tion at all times which guarantees perfect growth and devel- 
opment, both mentally and physically in children of all ages. 

19. These principles which make successful growth and 
good health in the infant and youth, if always followed, 
cannot miss in retaining also that good nutrition and health 
in the adult which always makes success possible to him. 

A MOTHER'S RESPONSIBILITY 

20. On this subject, the proper nutrition of infants and 
children, our mothers are perhaps farther behind the ad- 
vances of civilization, education, science and progress than 
on any other subject with which our educational and pro- 
gressive nation is acquainted. Where is the young mother 
whose mind is not concentrated most intently, night and 
day, upon the proper care, growth and development of her 
infant from the very hour it was born? Just look at the 
position in which she is too often placed — a graduate from 
our public schools, high schools, and possibly from colleges 
or universities — and yet when her first child is born and 
she is unable to nurse it, she has, forsooth, to ask some old 
friend, her mother or possibly, even a stranger, "What shall 
I feed my baby?" Just think of the trouble she has in get- 
ting the right answer as against the many wrong answers 
which she is sure to get just in proportion with the number 
of times and the number of persons of whom she asks that 
question. Out of a dozen answers, possibly no two will be 
precisely the same and very likely not one will be exactly 
right. Such is the problem which a very young mother 
encounters. Why should it be so ? Ignorance ! Ignorance ! 
That is the only answer to give to that question in this en^ 



20 FEEDING RULES FOR INFANTS 

lightened day, no matter where it is asked, in city or town, 
in country or village, anywhere from Maine to California. 

21. What a commentary upon our civilization! Yet, 
there are no members of our community who are keener 
or more anxious to advance in the right direction and be in 
the van of progress than our American women; and of 
these, there are none so keen and anxious on this subject 
as our American mothers, in their desire and determination 
to do all and everything they possibly can to secure that 
good health, strength and development necessary for their 
children. They fully realize that only good health and per- 
fect development can procure future healthy matured men 
or women and enable them to compete successfully in the 
great battle of life before them. 

22. It is not the fault of the young mother that she does 
not have this important information. It is the fault of our 
educational systems, for they have neglected to teach it. It 
will continue to be so until the nutrition of the human 
family is taught to our children as perfectly and as regularly 
as they are taught to read and write, and if. there is any 
one use to which our educational system could be turned 
with advantage to themselves, it would certainly be to en- 
able them to study this subject. When this is the case and 
all our children thoroughly understand what perfect nutri- 
tion is, and can regulate the diet according to the evidences 
thereof at any time, our young mothers will not require to 
ask, "What shall I feed my baby?" but will immediately 
give proper directions and also see that they are success- 
fully carried out. Their responsibility will be great, but 
the duty will be a pleasant one and one in which they will 
rejoice and take up with a happy heart, always cognizant of 
a successful result, feeling competent in their ability to do 



THE WORRIED AND ABUSED MOTHER 21 

that which is right and always recognizing promptly when 
an error has been committed by themselves or any one 
entrusted to do the work. 

23. What a strong contrast will then be our position to 
that of the present day, where ignorance reigns and this 
whole work is a mere guessing and trying ; guessing and 
trying by mothers, hoping to find something that will suit 
the infant's digestive power and give their weary heads and 
aching limbs a temporary rest and also secure for them 
quiet sleep. Any mother who has gone through the broken 
sleep, the tiresome rocking, the back-breaking walking and 
the incessant weariness that always accompany and follow 
a cross baby suffering from distressing indigestion, realizes 
that this is the result of efforts to digest food, the propor- 
tions of which are entirely unsuited to its age and tender 
digestive organs. Her present misery, her future gloomy 
thoughts and possible acquaintance with the undertaker, are 
all the result of her ignorance and consequent inability to 
extricate herself or her child from the painful and distress- 
ing position into which she has, like thousands of other 
mothers in the same position, innocently fallen. 

THE WORRIED AND ABUSED MOTHER 

24. The mother who has an infant that is very difficult 
to feed and whose growth has been very slow is continually 
in a very anxious and worried frame of mind. If she has 
been unfortunate enough to lose an infant previously, this 
intensifies her situation and she is usually so worried about 
the little one that she is inclined to talk a great deal regard- 
ing it among her friends. This is a mistake on her part, 
but she does not know it. The fact that she obtains advice 
from every woman with whom she converses and that 



22 FEEDING RULES FOR INFANTS 

scarcely any two of these women agree on this question, 
should be proof enough to her that it is a mistake to talk 
so much about the little one. Usually, the mother with a 
delicate baby has many callers, all asking about the little 
one, all giving advice ; the sum total of which, when counted 
up, amounts to six or eight formulas each day. Six or eight 
advices in a day are not a high estimate of the number the 
mother frequently receives. This repeated, continually, 
shows the anxiety and mental abuse to which the young 
mother is subjected. 

25. Where there is such great diversity of advice and 
suggestions, it is quite evident that there is no golden rule 
which all know alike and which she can adopt as her guide. 
If she would realize this fact and think the subject over 
carefully when alone, she would see that she cannot follow 
every advice ; therefore, she must select one particular 
course, adopt that one and follow it out intelligently. Try- 
ing to work in this way, will naturally drive her to select 
that course which is backed up by the most reason and 
intelligence, and such a one as she feels she can herself fol- 
low intelligently for her child's success and happiness. 

26. Now, who is there who can intelligently advise the 
young mother on this subject? Is it the mother who has 
had half a dozen children, now partially grown up, and who 
has nursed them all until nearly a year old? What experi- 
ence has she had about hand-feeding infants except dur- 
ing the second year ? Does she tell the young mother about 
the diarrhea, dysentery, fevers, convulsions and other dis- 
turbances from which her children suffered during the sec- 
ond summer, while they were strong and vigorous after the 
successful first year's nursing? She does not know that 
her irregular feeding and uncertain dietary were the cause 



THE WORRIED AND ABUSED MOTHER 23 

of her own infant's sickness and perhaps death during the 
second year. Just because she happened to have had half 
a dozen children whom she nursed during the first year and 
who were healthy while she nursed them and were sick 
more or less after she stopped nursing and hand-fed them, 
she and her friends think that, of course, she must know 
how to feed a young infant from three to six months old — 
that which she never did. She often thinks she knows 
enough to give advice about something which she is sure 
to spoil if she attempts to do it. 

27. Take all the other mothers, perhaps even some also 
who have never been mothers, yet who, because of their age 
think they know something about this matter. They, also, 
presume to advise on this vital subject about which they 
have had little, and some of them no experience whatever. 
One of them, perhaps, may have heard of a certain kind of 
food that did some person's baby good at a critical time. 
They think it took so and so, and was fed so and so, and, 
without any reason, they immediately proceed to give indis- 
tinct details and great certainties for which they vouch most 
unhesitatingly. 

28. Is there anything so simple in infant feeding that 
many women presume to know something about it which 
they think is good enough to try on another woman's deli- 
cate little infant? Would these same women presume to 
suggest to this mother how she should run her house, how 
to do her cooking or how to conduct herself in company? 
If they did, they would probably receive a sharp rebuke for 
their impudence; and yet, on this subject of feeding her 
infant, which is of far more vital importance to the mother 
and a subject requiring ten times more intelligence, they 
unhesitatingly say things and suggest changes for which 



24 FEEDING RULES FOR INFANTS 

they are not at all responsible and about which the great 
bulk of them invariably know a great deal less than the 
mother herself. 

29. The poor mother who is subjected to this abuse is 
the victim of their kindly intended pertinacity and their 
foolish, though well-meant, disposition to recommend some- 
thing that may, perhaps, be good for the infant, but they 
do not know whether it will or not. This mother is very 
much to be pitied for her sufferings and great mental tor- 
ture through these kindly but cruel and untimely advices, 
and she continues to suffer from this mental abuse until, 
through her own study and the education from her physi- 
cian, she reaches the point where she does not talk about 
her baby at all, or else she receives the officious advices of 
her friends in silence and inwardly pities them for their 
ignorance. The writer sees this result, frequently and con- 
stantly, in young mothers with their first infants. 

30. In days to come, this mother is competent to give 
advice to some other mother in like distress. Does she do 
it? Perhaps she does; but if so, she does it very sparingly. 
Realizing what an important subject this is, she usually 
advises the mother to seek instructions from the proper 
source ; that is, from a physician thoroughly competent to 
advise and direct her. She has learned enough from her 
own experience in a like condition not to presume to give 
advice on such a responsible subject and in a matter of such 
vital importance. 



CHAPTER II 
VARIETIES OF HUMAN MILK 

31. There is no food so suitable for a young infant 
as healthy human milk; and when a mother supplies enough 
of this to satisfy a healthy infant, its growth and success 
are assured. While the proper amount of milk of the right 
quality is the ideal food for an infant, there are only a lim- 
ited number of mothers who secrete that quality and quan- 
tity which insures success. The infant who suffers contin- 
ually from colic, looseness of the bowels and various kinds 
of digestive disturbances is certainly not getting a food 
which guarantees successful growth. It is possible that 
such an infant would, be better off if entirely weaned, pro- 
viding the weaning was done with a food suited to the 
child's digestive secretions. 

32. In order to thoroughly understand the proper nutri- 
ment for the young infant, it is necessary to look at the 
composition of human milk. Mothers should never con- 
sider milk as a single substance. The intelligent physician 
always looks upon it as a food composed of fat, sugar, pro- 
teid and salts, very largely diluted with water. 

33. In one hundred parts of human milk, there are 
eighty-seven and one-half parts of water and only twelve 
and one-half parts of food. In these twelve and one-half 
parts of food, there are four of fat, seven of sugar and one 
and one-half of proteids. This composition shows that 
nature's plan in feeding is to use a very dilute mixed food, 
and she has so arranged the digestive glands in the infant 
that they secrete different fluids suitable for the diges- 
tion of these various amounts of fat, sugar and proteids, 
each fluid being able to dispose of only that particular food 

25 



26 FEEDING RULES FOR INFANTS 

suited thereto. From this, it is plain that each food and 
the digestive fluid suited to it, must be correctly propor- 
tioned to each other for comfortable digestion and conse- 
quent successful growth and development. 

34. Where we are not able to supply human milk, it 
behooves us then to seek for a food as nearly similar thereto 
as possible. Only in the milk of the various animals do 
we find fat, sugar and proteids at all resembling that found 
in human milk; consequently, any dietary which does not 
have milk as the main source of its supply is unsuitable to 
the digestive power of the newly-born or very young infant. 
Only when the child becomes older and its digestive power 
has been materially increased, is it safe to introduce into 
its dietary any other foods than those which nature has indi- 
cated as essential for success (291). 

INJURIOUS HUMAN MILK 

35. Human milk, which is not absolutely perfect, and 
all forms of hand-feeding are liable to so irritate and dam- 
age some digestive glands that their power to secrete the 
necessary digestive fluid is very much reduced. In this 
way, the ability of the child to appropriate, perfectly, the 
amount of food necessary for its proper growth and devel- 
opment is so much lessened that the infant cannot be con- 
sidered as a perfectly healthy, normal child, and conse- 
quently, must be classed as the delicate or crippled one. 
Where the milk of the mother continually produces many 
colored mucous or slimy stools (49) and the child ceases 
to increase in weight, the continuance of such nursing must, 
necessarily, damage its digestive power, and very soon such 
infants are so much injured that it is with great difficulty 
they can be artificially fed thereafter (91). The amount 
of damage done, in these badly nourished infants, depends 



INJURIOUS HUMAN MILK 27 

upon their age and the length of time the nursing is con- 
tinued. The younger the infant is, when thus improperly 
nursed, the greater is the injury resulting therefrom; and 
the longer this unsuitable human milk is fed to the infant, 
the greater, of course, is the injury done to those particular 
digestive glands which suffer from this unsuitable food. 

36. It is important that mothers thoroughly understand 
this subject, in order to avoid the very serious injuries that 
they are continually, but innocently, inflicting upon their 
infants by persevering in nursing them after they have 
reached that point where their milk is no longer beneficial, 
but, on the contrary, very injurious. Great damage has 
been done and continues to be done to our offsprings by 
the ignorance of mothers on this subject. No mother de- 
sires to continue nursing as soon as she knows that her 
milk is injurious to her infant, but her strong maternal 
instinct nearly always persuades her that it is not injurious 
and she persists in nursing when the child suffers from 
colic, crossness, disturbed sleep, pale countenance and loss 
of weight, all being accompanied by foul, gassy, mucous or 
slimy and many colored stools. These symptoms just 
enumerated should and must be an infallible guide to every 
intelligent mother as indicating the time when her milk 
ceases to be nutritious, but has, on the contrary, become 
injurious to her infant (87). 

37. It is hard for the mothers of one or two months to 
realize this fact. It is also hard for the mothers of four, 
five or six months to realize this fact; but it is much more 
distressing for them not to promptly recognize the import- 
ance of this unhealthy milk condition while the child is yet 
healthy and vigorous and its digestive glands are in a 
proper condition to receive a well selected and suitable food 



28 FEEDING RULES FOR INFANTS 

which can be digested easily and perfectly. Some mothers 
wait until the child is debilitated and weakened by unsuit- 
able food which is so injurious to its digestive glands that 
they are unable to secrete the amount requisite to perfectly 
nourish it. This, unfortunately, is the condition too often 
seen in delicate infants suffering from malnutrition, nausea, 
vomiting, diarrhea, and frequently fevers also. 

38. From the above facts, it is apparent that the most 
important feature for the mother to realize while nursing 
her infant is the necessity for its continual growth and com- 
fort, and also to feel that, as soon as either of these is dis- 
turbed, every effort should be made to improve her milk 
secretion both by correcting her diet (53) and regulating 
her exercise so that she can secrete a better quality and 
the child be again made comfortable and gain weight. If 
she fail by these methods to correct the error, she should 
immediately consider the propriety and necessity of wean- 
ing the infant while it is yet strong and vigorous. 

39. In the early weeks of many children's lives, the 
mother's milk is nutritious and strong, giving rapid growth 
during that period ; but it often carries an irritable element 
also which continually causes colic and diarrheal disturb- 
ances. As the weeks pass by, this element in the mother's 
milk usually increases, while, at the same time, the nutri- 
tive qualities are decreased. In this way, the apparently 
healthy, vigorous, strong child passes into the pale, sickly, 
emaciated one and an early change of diet is the only pre- 
vention of this condition (84). This character of milk 
commonly appears with mothers who show no evidence of 
ill health in themselves, but remain strong and vigorous 
and may have several children, some of whom they were 
able to nurse. On the other hand, it appears that some 



IRRITATING BUT GOOD HUMAN MILK 29 

mothers always become fleshy and strong while nursing, 
taking to their own bodies that nutrition which good nurs- 
ing mothers give to their infants while they remain in a 
thin but healthy condition. 

40. This change in the character of milk, secreted thus 
early in these cases, is very nearly the same condition that 
occurs in almost every mother when she reaches that time 
in her nursing period when nature indicates that she should 
cease nursing her infant. This is nearly always coincident 
with the return of the menstrual function. 

IRRITATING BUT GOOD HUMAN MILK 

41. Many mothers secrete a good, rich, nourishing milk, 
but one which is very difficult to digest. The infants of 
these mothers nearly always thrive well, grow fat and 
strong, but are continually colicky, cross, restless and diffi- 
cult to care for. The stools of these infants are always fre- 
quent in number, yellow, with some mixture of green, 
mucous and undigested food (81). 

42. The error lies mostly in the amount of food which 
these children receive or in the diet of the mother. Such 
infants act better w T hen restricted in the amount they nurse. 
Mothers should be instructed in these cases to nurse only 
a short time, so that the infant will not receive more food 
than it can comfortably digest. Very commonly, it is neces- 
sary to restrict her nursing to three, four or five minutes 
actual time measured by the clock. Where a mother is 
careful thus to limit the time in which she allows the infant 
to nurse, she usually finds the uncomfortable symptoms of 
indigestion manifested by the infant lessened or entirely 
removed. Where this does not give the desired relief, she 
should pay very close attention to her own diet, lessening 
the amount of meat, milk and eggs which she consumes, 



30 FEEDING RULES FOR INFANTS 

avoiding all fruits, cabbage and tomatoes and probably less- 
ening the whole amount of food which she takes (54). 

43. Irregular feeding also on the part of the mother, 
either in the quality of the food or the quantity taken at 
any meal, tends to produce distress in the infant. These 
infants are always demanding more meals at night than 
they are able to digest. This craving for extra food is the 
usual condition of all infants suffering from digestive dis- 
turbances. Where these changes in the food do not make 
the infant comfortable, ten to twelve drops of saccharated 
pepsin before each meal will, very commonly, improve the 
digestion of this difficult milk and make the child much 
more comfortable and thrive very much better (152). 

NURSING MOTHERS 

44. Mothers vary in their nursing capacity. Some se- 
crete enough milk to feed their infants entirely during the 
first six to eight months of their lives. Some can nurse and 
continue to give good nourishing milk until the infant is a 
year old ; but no mother should try to nurse her child when 
it is beyond that age, unless the year ends in the hot sum- 
mer months. 

45. Nursing mothers may be divided into two classes : 
First — Those who can nurse perfectly. 

Second — Those who are able to nurse their infants, but 
do it imperfectly. 

The first class may be sub-divided very largely, according 
to the length of time they can nurse. Some mothers can 
nurse their infants successfully for only one, two or three 
months, and others, who may be classed as the most success- 
ful ones, can nurse perfectly from six months to a year. It 
is evident from this that the length of successful nursing 
power varies from a few weeks to a year. 



INSUFFICIENT HUMAN MILK 31 

The second class are those whose milk may or may not 
be abundant in quantity but is imperfect in quality and 
always produces injurious influences and bad results upon 
the infant. Their infants grow very little and imperfectly, 
or even waste away, steadily becoming smaller. These 
cases are considered under the head of injurious milk 
(35-40). 

46. A mother who can nurse her child successfully 
should always do so, even though it may impose heavy 
duties upon her, or may compel her to endure pain resulting 
from sore nipples for weeks, if necessary, in order that she 
may reach that very desirable success which is always 
obtained by feeding healthy human milk (76). 

47. The mother who cannot nurse successfully, but who 
is amply able to pay for a wet-nurse to do it for her, should 
always, if possible, prefer a wet-nurse to hand-feeding. 

INSUFFICIENT HUMAN MILK 

48. It often happens that an infant is cross, restless and 
unable to sleep on account of the scanty amount of the moth- 
er's milk. In this case, a baby always loses weight and 
becomes pale or the weight becomes stationary, and it is 
peevish and fretful after being nursed, sleeping poorly, wak- 
ing frequently and sucking its hands (345). This infant 
usually has very small, infrequent stools, but they are per- 
fect in character. In this case, the child is suffering from 
hunger, and on that account cannot sleep continuously. 
Infants acting in this way should be fed immediately after 
nursing with a solution of sugar- water (407) and cream. 
If it takes this food greedily, it is proof of the shortage in 
the milk supply and will demand better care of the mother 
to enable her to secrete a larger amount (54). 



32 FEEDING RULES FOR INFANTS 

Other proofs of insufficient milk is when the child grasps 
the nipple and lets go frequently or continues to nurse 
twenty to thirty minutes. These cases will also demand 
substitute feeding in addition to the nursing (95). Where 
the stools are of a green and mucous character, it may be 
necessary to feed entirely ; but such cases should always be 
referred to a physician for direction, as these stools show 
a serious error in the food or in the child. 

POOR HUMAN MILK 

49. Many a mother is distressed on account of the rest- 
less, cross, crying condition of her infant during the first 
few weeks of its life. Where this condition is accompanied 
by frequent green and mucous stools, the disturbance in the 
infant is usually due to the imperfect quality of the mother's 
milk. This is always increased when she is taking a laxa- 
tive to move her bowels or medicine of any kind whatso- 
ever (57). Where she suffers from any feverish condition, 
where she loses her sleep from any cause, where she is wor- 
ried and tired out in caring for the baby herself, where she 
is feeding very heavily on meat, milk and eggs, and partic- 
ularly where she is suffering from indigestion, it is neces- 
sary that these conditions be removed before it is possible 
for the infant's stools to become yellow in color, of a pasty 
consistence and free from mucus, as healthy nursing stools, 
should always be (52). 

FOOD OF THE MOTHER 

50. Nursing mothers usually require to avoid certain ar- 
ticles in their diet in order to secrete a healthy nourishing 
milk which is not difficult to digest or liable to cause colic or 
other disturbances in the infant. As there is a great differ- 
ence in the digestive power of infants — some being able to 



FOOD OF THE MOTHER 33 

digest milk from almost any mother and others experien- 
cing a difficulty in digesting the most suitable milk — so will 
it be possible for a mother to take almost every kind of 
food when her infant has this strong digestive power. 

51. The mother whose child has weak digestive organs 
requires to be intensely careful in selecting her food and 
the amounts thereof. 

52. Again, many mothers have weak digestive organs 
themselves and can, with difficulty, digest enough food to 
nourish themselves and their infants. A mother who thus 
suffers from indigestion herself requires to pay close atten- 
tion to her own diet, selecting only those foods that she can 
digest most comfortably so long as they procure good, 
healthy milk for the infant. 

53. These mothers and those whose children are colicky 
and cross require to avoid everything that is raw and sour 
and large amounts of cold drinks. This excludes tart fruits, 
raw or cooked, also pickles, tomatoes and cabbage. In 
addition, mothers will usually find that free indulgence in 
animal foods — meat, milk and eggs — is likely to make a 
cross, colicky infant. 

54. Regularity in the mother's diet, exercise and rest, 
are absolutely necessary to secure a good nutritious food 
for the infant. While there are many mothers who are able 
to do heavy labor, eat any kind of food and grow healthy 
children at the same time, they become no law or rule for 
mothers with weaker digestive powers and more delicate 
children, and great damage is often done through advice 
suggested by these vigorous mothers to young mothers with 
their first babies, by inducing them to. eat all kinds of food, 
and frequently, in amounts which will be in excess of their 
digestive power, thus sickening the mothers and damaging 



34 FEEDING RULES FOR INFANTS 

the infants. Her own good digestion and the happy, com- 
fortable condition of the infant must always be the moth- 
er's guide in selecting the kind and amount of her food 
(42). 

DRINKING MILK TO MAKE MILK 

55. There is a common idea prevalent among mothers 
that to make milk it is desirable to drink milk in large quan- 
tities. This is an error frequently made and many use it as 
a drink instead of water for this purpose. A mother should 
remember that milk is a food as well as a drink, and that if 
she takes it in large amounts she will produce biliousness 
and indigestion in herself. Aside from this effect upon the 
mother, it makes her milk very difficult to digest and usu- 
ally causes colic with mucous and yellowish-green stools in 
the infant. 

56. Where it is necessary to take drinks in large quanti- 
ties or beyond the usual amount in order to secrete the full 
quantity of milk necessary for the nourishment of the 
infant, the mother should always select a weak tea or thin 
gruel well boiled. These may be flavored only with the 
amount of milk or cream necessary to make them palatable. 
The gruel should not be made so as to be a meal more than 
a drink, for if it is made richer than a drink it will surely 
cause indigestion in herself and thus reduce the amount of 
milk she secretes. Beer and extract of malt are used for • 
this purpose also, but they do not equal the gruels in the 
nourishing qualities of the milk they produce. 

MOTHERS TAKING MEDICINE WHILE NURSING 

57. There are very few medicines which are allowable 
for a mother while nursing her infant. It is an exception 
where she can take medicine and, at the same time, have a 
comfortable, happy and healthy infant. The rule is that all 



MOTHERS TAKING MEDICINE WHILE NURSING 35 

medicines act upon the child with greater force than upon 
the mother. Opiates taken by the mother produce a very 
heavy, sleepy effect upon the infant and also cause consti- 
pation. Laxatives, when taken by the mother, act very vig- 
orously upon the child, producing indigestion, colic and 
loose mucous stools. Nearly all tonics, and especially prep- 
arations of iron, cause griping and colic in the infant with 
some looseness of the bowels and disturbed sleep. 

58. As the above three classes of medicine are the ones 
principally taken by the mother and they produce these 
injurious influences in the infant, it is apparent that, for 
successful, happy infants, all medications of the above kinds 
must be entirely avoided. 

59. Constipation, of any degree, in the mother, should 
always be overcome by judicious diet and the use of hot 
water enemas, as these cause no disturbance in her milk 
secretion and consequently produce no injurious influences 
in the infant. 

60. Where a mother is in poor health herself, it is im- 
possible for her to give as good a quality of milk as she 
could if she was entirely well. It may be necessary, while 
she is in this condition, to receive medicinal treatment. 
While thus sick, she must be guided entirely by the direc- 
tions of her physician. It is very commonly necessary, in 
short sicknesses, that she take such medicines as are needed 
in order to improve her health and retain a good milk secre- 
tion. Though the infant may be disturbed by this treatment 
it is requisite to continue it for such a length of time as is 
necessary for her cure. Where the treatment has to be con- 
tinued for a long time and the infant's digestion is seriously 
disturbed thereby, it becomes a question whether the child 
should not be entirely weaned. Certainly, when the infant 



36 FEEDING RULES FOR INFANTS 

is making no progress physically, but, on the contrary, is 
daily becoming paler and its flesh softer, the situation pre- 
sents great doubt as to the propriety of continuing the nurs- 
ing (100). 

61. Acute sicknesses on the part of the mother, when 
not accompanied by any serious infection of her blood, such 
as is present in typhoid fever, puerperal fever, scarlet fever, 
etc., do not necessitate the weaning of the infant as long as 
she continues to secrete enough milk to partly nourish it, 
especially when this acute sickness does not last more than 
a week or ten days. Usually, in these short sicknesses, the 
ability of the mother to continue secreting a fair amount of 
milk is a satisfactory guide in nursing the infant so long as 
it does not show serious disturbances in its digestive organs, 
sleeps well and retains its healthy appearance. 

62. While the above rules are generally the guide on 
this subject of nursing during sickness, this question is 
always of such great importance that it must be under the 
guidance of the physician in charge. 



CHAPTER III 

CONDITION OF THE NURSING MOTHER 

63. The young mother is frequently confronted during 
the first few weeks after the child's birth with very great 
difficulty in nursing her infant on account of the soreness 
of the nipples or the much more painful and aggravating 
condition resulting therefrom, viz., a suppurating or bealing 
breast. The difficulties she thus encounters very frequently 
decide the question of weaning or continued nursing. The 
future of the infant is too frequently lost sight of for the 
time being, and it is forced to commence fighting the battle 
of life on foreign food long before its digestive organs are 
designed by nature to take care of such food, and often 
long before the mother has any conception of the great 
uncertainties which always accompany hand-feeding of 
such a young infant, if not properly done. Certainly, to 
the mother or nurse who has had no experience in this 
important duty, this subject is sure to present great difficul- 
ties and to result in a very improperly nourished infant with 
liability to death, itself, in weak or delicate infants. 

64. Where both breasts suppurate and contain pus, it 
becomes necessary to wean the infant. In this condition, 
the mother has no choice. This is a very painful and unde- 
sirable result, which can usually be obviated entirely by the 
proper disinfection and care of the nipples from the begin- 
ning, after each time the infant nurses (72). 

SORE NIPPLES 

65. Different factors contribute to the production of 
sore nipples in the nursing mother: 

37 



38 FEEDING RULES FOR INFANTS 

1st. Natural formation, such as shortness of the nip- 
ple and the thickness thereof. 

2d. Tender skin of some women. 

3d. Wrong habits in nursing — nursing too long. 

4th. Shortage of milk. 

66. Short nipples are due to the length of the milk ducts. 
Young women, during their first pregnancy, should be 
aware of the liability to sore nipples when first commenc- 
ing to nurse. They should make it a habit of regularly 
elongating the nipples by pulling upon them during the last 
three or four months of the pregnant period. Where they 
are naturally short and this is not done, as soon as the 
breast swells up with the first rush of milk, the short nipple 
does not stretch sufficiently to rise above the surround- 
ing structures, but, on the contrary, remains so buried that, 
in many cases, it is impossible for the infant to grasp it. 
The result is that the milk cannot be drawn from the breast, 
or if it is drawn by the infant, there is so much strain upon 
the nipple in the effort to grasp it that it soon becomes very 
sore and the pain of nursing cannot be endured. This 
induces the mother, in many instances, to wean the child 
and condemn it to artificial feeding while she has an abun- 
dance of milk which cannot be obtained except by a breast- 
pump (78). Constant use of the breast-pump in these cases 
very soon stops the secretion, as no woman can continue to 
secrete her milk regularly when it is drawn away only by 
artificial means. It is absolutely necessary, for a continued 
milk secretion, to have the infant nurse the breast directly. 

67. The strength of the outer layer of the skin varies 
very greatly in different women. Even when the nipple is 
well formed and of abundant size, many mothers suffer 
great tortures from the abraded condition of them after the 



TREATING SORE NIPPLES 39 

first few days' nursing. This is due to the fact that the 
cuticle, or outer layer of the skin, is very thin and easily 
injured, and where such women are not careful to nurse as 
little as possible and have long intervals between nursings, 
they soon find this work very painful indeed. 

68. Nipples that are very sore should not be used so fre- 
quently; in other words, the infant may be partly fed and 
partly nursed, thus allowing the mother a longer rest be- 
tween nursings, and, consequently, better prospect of heal- 
ing these sore, tender parts. 

69. Many a mother with well-formed nipples and good, 
healthy skin suffers from sore nipples, because she allows 
the child to nurse much longer than is necessary. This 
mother usually goes to sleep while the child is nursing at 
night, and by allowing the infant to hold the nipple in its 
mouth while sleeping, so softens the skin by the moisture 
of the child's mouth, that it soon becomes sore. 

70. Long nursing, when there is not enough milk in 
the breast to satisfy the child, very commonly causes sore 
nipples. 

TREATING SORE NIPPLES 

71. In order to prevent sore nipples, some of the diffi- 
culties above enumerated can be avoided. In addition, the 
mother should^ during the last two months of her preg- 
nancy, massage and rub the skin thoroughly over the nip- 
ples when it is in a wet condition. By doing this regularly, 
she treats the nipples as nearly like what the child will do 
as possible. It is not sufficient to rub the nipples while they 
are dry, nor is it right to apply alum water, alcohol or other 
applications of a character entirely dissimilar to the moist- 
ures which the child supplies when nursing; in fact, the 
nearest approach which a woman can do is to moisten the 



40 FEEDING RULES FOR INFANTS 

nipples thoroughly with her own saliva or cow's milk, and 
apply the friction and massage while in this moist condition. 
If she does this faithfully and continually during the two 
months prior to her accouchement, there is not much like- 
lihood of well-formed nipples becoming very sore when the 
child nurses (66). 

72. Great stress is laid, at present, upon the necessity 
of using disinfectants, such as solutions of boric acid, on 
the nipples immediately after nursing. This is a valuable 
practice, but it is possible to bathe them too freely during 
the early nursing period, and thus cause irritation. Where 
they are sore, bathing with boric acid water (one teaspoon- 
ful to a cup of water) after each nursing, disinfects the 
sore skin and thus prevents absorption of poisonous matter 
which would cause suppuration or bealing of the breasts 
(63). 

73. A mother suffering from sore nipples complains a 
great deal of the pain and irritation caused by the contact 
with- her clothes in the intervals between nursings. Many 
use oiled cloths to relieve this irritation and prevent their 
clothes from sticking to the sores on the nipples. This con- 
tact with clothes can be avoided by making little pasteboard 
cones, which are placed upon the breasts after nursing and 
thus hold the clothes entirely away from the sore parts. 

74. These pasteboard cones are very simple and are 
easily made as follows: A round piece of pasteboard, six 
inches in diameter, is all that is needed. Cut a hole in the 
center as big as your finger and then cut from that to the 
outside edge. These two edges thus made can be over- 
lapped enough to make the necessary height of cone and 
are then stitched together. These cones give great comfort 
to the mother, avoid the clothes crowding the nipples down 



THE NIPPLE SHIELD 41 

into the breasts, allow soothing dressings to remain in con- 
tact continuously, and materially hasten the process of 
healing. 

75. Reversing the position of the infant during the nurs- 
ing period so as to make it grasp the nipple on the healthy 
sides thereof, rather than on the sore sides, will frequently 
assist very much in the process of healing. In this way, the 
child's feet will be held under the right arm while nursing 
from the right breast and the same relative position will 
be assumed while nursing on the left side. 

76. While nursing a sore nipple is very painful to the 
mother and hard to endure, yet, compared with that mental 
anguish, worry, loss of sleep and anxiety always accom- 
panying the care of an improperly fed infant, it is very 
small indeed. All sore nipples finally become well, under 
careful handling and good treatment (46). 

THE NIPPLE SHIELD 

77. Where nipples are intensely sore and great pain 
results therefrom, the nipple shield generally gives decided 
relief and enables the mother to continue nursing when she 
would be compelled to wean the child entirely if she did 
not have some protection of this kind. 

Different forms of nipple shields are used. One is the 
thin rubber one, which has a broad flange covering the 
breast, thus enabling the mother to hold it in position while 
the infant is nursing. The other is a glass one, with flange, 
which is applied over the tender part and finishes with a 
small rubber nipple for the child to grasp. Either one of 
these makes a very good application to save the mother 
pain and suffering, but both are very poor substitutes and, 
frequently, infants refuse to use them. Great care must 



, 



42 FEEDING RULES FOR INFANTS 

be taken in keeping these nipples thoroughly clean and dis- 
infected (361). 

THE BREAST-PUMP 

78. Occasionally, it is necessary to use a breast-pump 
where nipples are so short or so sore that it is impossible 
for the child to nurse. With some mothers, this is very 
successfully done. With others, it is an impossibility. The 
most suitable form of breast-pump is that with a glass body 
and rubber bulb. Beneath this body, there is a cup blown 
in the glass which receives the milk as fast as it comes from 
the breast. The ordinary form of breast-pump requires to 
be emptied and reapplied every time it fails to draw. The 
improved breast-pump has a valve in the rubber neck which 
enables the bulb to be worked more or less continuously and 
thus increases the suction power upon the breast. As the 
rubber very soon becomes old and hard, it leaks air where 
it is applied over the glass. It is necessary to watch this 
point and keep it close by tying a string tightly around it. 



CHAPTER IV 
NURSING INFANTS 

79. All nursing infants may be divided into two classes : 
1st. Those who are perfectly nourished, comfortable, 

happy and make weight rapidly and regularly. 
2d. Those who are imperfectly nourished. 

80. These children of the first class always yield stools 
that are yellow in color and of a pasty consistence, from 
three to six in number daily, during the first month, grad- 
ually lessening to one or two daily as they grow older. 

81. There is another class of those perfectly nourished 
infants who continue to thrive regularly, but who suffer a 
great deal from colic and disturbed sleep and yield numer- 
ous stools, orange-yellow in color, frequently mixed with 
green, and at times, curds. The mothers of this class either 
nurse them too freely and too frequently, or eat food them- 
selves which gives this green, slimy character. This is the 
class of children which has left the wrong impression upon 
mothers, giving them the idea that the colicky child is the 
healthy one. It is also this class which raised the idea that 
an infant must have a three-months' colic. The mothers of 
these children secrete a good, strong, healthy milk, but they 
lack the necessary discretion in their own diet or exercise, 
nurse irregularly or too freely, and thus destroy the happy 
and comfortable condition of the infant. These are the 
mothers who can, most generally, so regulate their own 
condition and management of the infant as to make it thrive 
successfully (42). 

82. Imperfectly nourished infants are those who cannot 
be made comfortable and happy, or gain weight steadily 

43 



44 FEEDING RULES FOR INFANTS 

without additional food, and are treated under the head of 
"Nursing Infants Requiring Additional Food" (87-98). 

REGULARITY IN NURSING 

83. Regularity in feeding an infant is necessary for its 
successful growth and happiness. The new-born infant 
should be fed about every hour and a half during the first 
month and about every two hours during the second and 
third months. The time may be extended to three and a 
half hours, as the infant grows older and shows an ability 
to go a longer time without becoming hungry. This regu- 
larity in hours applies only to the daytime. Infants should 
always be allowed to sleep as long as they will during the 
night. Many mothers make serious mistakes by feeding at 
irregular intervals, or whenever the child cries for it. In 
this way, the infant is often fed every half hour because it 
cries from any cause, or it may not be fed for three hours 
because it is sleeping. There is no reason for this irregu- 
larity in a healthy child. Where an infant is always nursed 
because it cries or is cross, it remains cross and colicky 
simply because this irregularity in feeding overloads the 
digestive tract, and thus causes decomposition rather than 
digestion of the food, and this perpetuates the cross condi- 
tion of the child. Many mothers, feeding in this irregular 
way, so imperfectly nourish their infants that they are, in 
time, compelled to wean them entirely. 

84. An infant should not be allowed to sleep in the day- 
time and be wakeful at night. Great care should always be 
taken by the mother to avoid the child's habit of thus con- 
verting night into day. At nearly the regular feeding time, 
the infant should be taken up and nursed during the day, 
whether asleep or awake. Only in this way, by regular day 



LENGTH OF TIME FOR NURSING 45 

feeding, can the child receive enough food and be well 
enough nourished to enable it to sleep steadily during the 
night. No healthy infant should nurse more than three 
times during the night, and only very young infants require 
this number of night feedings. Older infants, when well 
fed in daytime with good nutritious food, will not require 
more than one, or at most, two meals between 6 P. M. and 
6 A. M. the next day. Many infants, when properly fed, 
receive no food after being put to bed. This will mostly 
occur with infants after they are five or six months old. 

LENGTH OF TIME FOR NURSING 

85. The length of time infants should nurse varies with 
the condition of the mothers and also with the condition of 
the children. The milk ducts in the human breast vary in 
size in different women, and occasionally, in different 
breasts of the same women. Where they are large and the 
milk supply is abundant, an infant can usually obtain a full 
meal in from four to five minutes. Where these ducts are 
small, it will require twelve to fifteen minutes to satisfy the 
infant. Where a healthy child continues to nurse longer 
than the usual time, it is generally due to a deficiency in the 
milk secretion. Infants who nurse from twenty to thirty 
minutes are getting very little nourishment. Such children, 
when this length of time is a habit, are always poorly nour- 
ished, colicky and cross. Mothers should remember that, 
where the child nurses an unusual length of time, it is more 
likely due to a deficiency in the milk secretion than to the 
infant's extraordinary appetite (48). 

OVERFEEDING NURSING INFANTS 

86. Mothers having a large supply of milk are very 
much inclined to overfeed their infants when this milk is 



46 FEEDING RULES FOR INFANTS 

of good quality. Usually, this is not attended with any 
serious injury to the infant, but it causes an extraordinary 
drain upon the mother's strength. Some mothers have such 
an abundance of milk that they purposely cause the child 
to nurse freely, as in that way they are relieved of the strain 
and tightness upon their breasts and the child very easily 
dislodges this extra load by vomiting; but, in doing this, 
they fall into the habit of nursing their infants whenever 
they feel uncomfortable. Very little can be said against this 
habit, save the fact that the mother is thus debilitated and 
there is danger of producing indigestion in the child; but, 
where the milk is perfect, healthy infants are seldom dam- 
aged in this way if they vomit immediately after nursing, 
for nature has provided the infant with power to reduce the 
meal by vomiting the surplus food almost immediately after 
it is taken. This act of vomiting on the part of the child 
is not accompanied by nausea or other disturbances. Except 
for the soiling of its clothes, the infant suffers no annoyance 
from this unnecessary use of its digestive organs. Where 
it does not vomit, the surplus food passes into the intestine 
and causes colic, with mixed green and yellow gassy stools. 

NURSING INFANTS REQUIRING ADDITIONAL FOOD 

87. Many mothers cannot continue to nurse their infants 
successfully without the addition of some one of the ele- 
mentary foods that are found in milk. If this addition is 
not made early, while the child is yet thriving and its diges- 
tive organs are in a healthy condition, it will soon reach a 
point where its mother's milk becomes so irritating to the 
digestive glands that they lose their power to secrete the 
quantity of digestive fluid necessary for the daily nourish- 
ment and growth of the infant. These infants always show. 



NURSING INFANTS NEEDING ADDITIONAL FOOD 47 

foul, mucous, many colored stools. When the irritation 
reaches this point, it becomes a very difficult matter to 
digest that amount of fat, sugar and proteid needed for suc- 
cessful growth and development. This mistake is com- 
monly perpetuated in these cases too long, before the diet 
is properly adjusted, and so cripples and injures the infant's 
digestive power that it always requires very low feeding for 
many weeks and even months, in some cases, to again place 
the child in a good growing condition. It never does be- 
come the healthy, vigorous infant which nature promise4 
in the first place and which would have been the result, if 
the mother's milk had been of the proper quality or the 
additional food had been properly substituted at the right 
time (37). 

88. Where these corrections are delayed too long, the 
digestive glands are so damaged that the child continues to 
pine away, resulting in malnutrition, marasmus and perhaps 
death. Such are some of the cases which always die during 
the coming heated term with the first light attack of diar- 
rhea (93). 

89. These children may be divided most easily by the 
character of their stools, as follows: 

1st. Those with yellowish, brown, or orange, watery 
stools which penetrate the diapers, but which leave little or 
no substance on the surface thereof. 

2d. Those with soft stools of a pale yellow color, con- 
taining mucus and almost entirely covering the surface of 
the diaper. 

3d. Those with mixed green or yellow colored stools, 
carrying mucus or slime and dotted all through with little 
yellowish particles of stool, which look like curds. Some 
say children of this class leave a fairly formed stool, or 



48 FEEDING RULES FOR INFANTS 

parts of the stool will be fairly formed, pale yellow in color 
and the balance of mixed characters, as above described. 

90. All these children with imperfect stools are cross 
and colicky, requiring constant attention and sleeping 
poorly. 

91. These infants of the first and second classes usually 
thrive well and make weight regularly during the first few 
months of their lives, but they soon reach a point where 
they cease to gain weight until they are weaned or a food 
suitable to their digestion has been partly substituted. While 
they are making weight, their digestive glands are being 
irritated and gradually damaged so that there will, in a few 
weeks, be very greai difficulty in adjusting a food suitable 
to their decreased digestive power which will be sufficient 
to secure steady and satisfactory progress after weaning 

(37): -'■"'"" 

92. Those of the third class, above described, seldom 
thrive or make weight satisfactorily. They always look 
pale, thin and white and also present the appearance of 
being partly starved ; in fact, this partly starved appearance 
is very commonly the condition of children whose mothers 
are never able to give them a sufficient quantity of any kind 
of milk and they usually nurse them from twenty to thirty 
minutes, there not being enough milk in the breast to satisfy 
them in the usual five or ten minutes requisite for nursing 
from the healthy, good-secreting breast (48). The moth- 
ers of this class of children usually become fat themselves, 
but many of them are in poor health or are overworked, 
worried, tired out and should have assistance in their duties 
before they can nourish their infants properly. Should 
they fail to produce healthy stools in their infants after 
receiving this requisite assistance and rest, they should at 



NURSING INFANTS NEEDING ADDITIONAL FOOD 49 

(Mice give nourishing additional food to the infant, and fail- 
ing still after this effort to produce healthy stools, entire 
weaning should he considered necessary (98). 

93. In all these cases of imperfect nutrition, it is well 
to commence with the additional or supplementary foods as 
soon as the stools show the unhealthy characters above de- 
scribed. A great error occurs when the children are allowed 
to continue, exclusively, on a dietary which shows other 
results than the correct ones indicated by the healthy yellow 
stool. Parents may feel sure that the infant's digestive 
glands are being gradually damaged and injured even while 
they, apparently, are healthy and growing rapidly. When 
the stools show these unhealthy characters, through neglect 
to correct these errors at the proper time, the foundation of 
future indigestion, loss of weight, colic, crossness, diarrhea, 
and many other conditions of malnutrition is laid (88). 

94. As these nursing infants are only consuming the 
sugar, fat and proteid supplied by the mother, it is easy to 
see that the error lies in the character of some one of those 
elements she secretes. To correct this error, sugar, fat or 
proteid from cow's milk should be substituted in small quan- 
tities two or three times each day until correct evidence of 
such substitution is noted upon the stools (104). 

95. As the stools in these cases are usually too frequent; 
it is seldom desirable to commence with fat, which is relax- 
ing in its effects, but rather select that element which is 
constipating. Skim-milk diluted with about five times as 
much boiled water and slightly Sweetened to improve its 
taste should be fed. The amount of this skim-milk must 
not be more than one to three ounces daily, diluted with 
water, during the first month. This should be given in four 
meals, giving one ounce at each meal. An infant two months 

4 



50 FEEDING RULES FOR INFANTS 

old may take four to six ounces of skim-milk daily, diluted 
with water and sweetened. An infant of three months, 
from six to eight ounces thus diluted. This food may be 
given in smaller quantities before each nursing or given in 
the above amounts as substitute meals. The latter plan is 
generally the easier and more satisfactory. It should be fed 
alternately with the nursing meals. The exact amount 
which may be fed must always be governed by the happier 
condition of the child and the healthier condition of the 
stools ; in fact, the character of the stools is the only true 
and safe guide, as it gives you direct proof each day of suc- 
cess or failure and whether the digestive glands are being 
irritated by the character of the food they are called upon 
to digest. 

96. Should the skim-milk cause too much constipation, 
show curds or an extra gassy condition, it would be requisite 
to partly substitute whey for it (395), or increase the 
amount of sugar gradually, being guided by the softness of 
the stools (243). Cream and skim-milk in these cases must 
generally be pasteurized and peptonized also, to secure easy 
digestion. 

97. In the feeding of either of these elements — proteid 
or fat — it is not necessary that the proportion of seven per 
cent, milk-sugar be always maintained in the dilution of 
them. More may be used for some infants. In cases with 
very watery stools, sugar often increases this trouble. If 
the sugar is not provided for in this way, a starch substi- 
tute must be used or the child's nutrition will not be perfect. 
The mother must always remember that, in nature's plan, 
sugar forms over half of the food in the infant's dietary and 
a reduction of this food cannot result in anything but the 
child's imperfect growth, pale countenance, unhappy con- 



IMPERFECT NURSING DEMANDING HAND-FEEDING 51 

dition and poor nutrition if starch, or another sugar is not 
substituted for it (407). 

98. From the above conditions and evidences of im- 
proved results by a perfectly digested additional food, the 
mother must realize the absolute necessity of only nursing 
the child when she produces these healthy formed stools. 
Her own maternal desire and love of the work must be 
entirely subject to the child's future success. She does not 
wish to do otherwise, but the great difficulty is in making 
mothers realize, while nursing their infants, no matter 
what their age, that in order to secure the future success of 
the child, they must be guided by the present evidences of 
success or failure given daily by changes in weight and 
those proofs which the stools present regularly in their gen- 
eral characters. No more should she disregard these evi- 
dences, as daily presented to her, than disregard the evi- 
dences of incorrect work, when her preserved fruit fer- 
ments, her bread turns sour or her cakes fail to rise in the 
making. In all these cases, she knows an error lies in her 
work. With her nursing infants, she must, immediately, 
look at failure of increasing weight and unhealthy stools 
as due to an error, but one of such an immensely greater 
magnitude that it demands serious thought and prompt 
correction much more than those little errors above cited 
in her culinary Work (89). 

IMPERFECT NURSING WHICH DEMANDS HAND- 
FEEDING 

99. Where a nursing infant is unhappy and does not 
thrive well, this result is caused by an insufficient amount 
of suitable mother's milk or by the indigestible character 
thereof. Where the mother's milk is suitable in character, 
but insufficient in amount, the child is cross and pale, but 



52 FEEDING RULES FOR INFANTS 

is free from gassy discharges, and has healthy stools, sf ria 
in size (48). This infant can continue to nurse by ha^ m S 
additional food, as per feeding schedules (573-579). 

100. The digestive glands of the infant, with cont mu * 
ously green, foul, slimy stools, are being seriously inji ire d 
and future success demands that it be weaned entirely an( ^ 
fed according to the feeding schedules. 

101. The difficulties in changing food, the damage d one 
to the infant's digestive glands and the mortality are m ~ 
creased in direct proportion to the length of time the inf an t 
has been showing these green, slimy, foul stools (89). 

102. In selecting the amount of food, the weight of tne 
infant must be the guide, and meals one-third smaller tl ian 
those in the schedules should at first be tried. Where the 
proportions in one schedule do not seem to give a heal^y 
stool and make the child happy, those in another should be 
tried, always using that one which makes the child comfc )rt ~ 
able and gives not more than two healthy, well-forn ie( i 
stools each day (294, 441). 

103. As these infants, who demand immediate weaniP£» 
have always been damaged in proportion to the length °* 
time they have been passing those unhealthy stools, tl ie Y 
will, usually, lose weight for some time on the new foPd. 
This occurs until healthy stools are produced, as a sv ire 
foundation for success. When these have been found, t ne 
same proportion of foods can be increased carefully, as ld n S 
as the stools remain perfect and the child shows a regu* ar 
advance in weight. These changes often require two t° 
four months in the badly damaged, but where the weani n g 
is done in a week or two after the unhealthy stools appe ar > 
only a few days or weeks, usually, are needed to find t" 6 
correct proportion of foods for the new dietary (228). It 



SUDDEN WEANING 53 

is in this class of infants that the greatest damage is done 
and the greatest mortality follows (181). 

104. Infants under three months old who demand wean- 
ing will be able to take very little starch while being 
weaned; consequently, they must be fed with the fat, pro- 
teid and sugar in cow's milk. For such cases as these, those 
parts of the schedules which contain no starch are most 
likely to be suitable. Small feedings from the schedules 
should be given and alternated with the nursings before the 
child is weaned (95). Where this is successful, parts of 
the stools will show characteristics of the new food and the 
rest characteristics of the mother's milk. As soon as the 
new food gives the healthy stool, the infant should be 
weaned entirely, and all the nourishment given should be 
in small meals from the schedules (57 3-579). 

105. If the infants are over three months old when 
weaning is demanded, it is generally found that the new 
dietary should carry a fair proportion of starch. The rea- 
son for this is that the fat, sugar or proteid in the mother's 
milk has damaged the digestive power of the infant, and it 
is better to go, partly, to an entirely new food and thus rest 
those injured parts. For these cases, those parts of the 
schedules carrying starch are more successful, but the fat, 
sugar and proteid must be fed in small proportions with 
the starch. It is always best to commence the new food 
by adding only one of these articles to the starch, making 
further additions when healthy, well-digested stools allow 
this to be done (303). 

SUDDEN WEANING 

106. Many mothers make serious mistakes in deciding 
to wean their infants suddenly. This should never be clone 
except in extreme cases, where the child's life is in danger 



54 FEEDING RULES FOR INFANTS 

and the physician directs her to do so. Digestive troubles 
of very serious characters are sure to follow sudden wean- 
ing at any age, unless the child is fed in very small amounts, 
until the new foods show perfect digestion. Under any 
plan, sudden weaning means serious loss of weight in the 
infant. This is due to the sickness following hasty weaning 
when improperly done, or due to the very limited dietary 
which can be given with safety at this time. Rather than 
wean an infant before it has reached an age where it is able 
to digest liberal diet, it is always preferable to gradually 
substitute the mother's milk with meals of the new food, if 
by doing so the infant is made happy and the stools show 
good digestive results (87-98). 



CHAPTER V 
COW'S MILK FOODS 

107. This subject presents difficulties of various kinds, 
according to the location, whether in city, village or coun- 
try. The general understanding at the present day is that 
suitable milk is only that taken from the herd, or many 
cows, rather than from one cow. On the principle that if 
you make a mistake in selecting milk, it is better to make a 
small one than a large one, the method of taking herd milk 
rather than from the individual cow, is correct. In a city, 
milk is usually sold from the herd and not from the indi- 
vidual cow; consequently, experience in feeding infants in 
a city is almost entirely confined to herd milk, from sixteen 
to twenty-four hours old when delivered. 

108. There are objections, however, which can be raised 
to each and every way of selecting the milk supply. Per- 
haps the way open to the least objections is to take fresh 
milk from the individual cow, when trial shows that her 
milk is suitable and her food and care are entirely under in- 
telligent control. This method is applicable either in the 
city or country, for those who are able to bear the expense 
of keeping their own cow; but where the milk has to be 
bought, the proper selection thereof must depend upon the 
intelligence and industry used in judging a suitable milk 
and in looking into the care and cleanliness of the milk 
dealer. 

109. Milk, to the ordinary observer, requires little 
thought or attention. In homes where there are no children 

55 



56 FEEDING RULES FOR INFANTS 

or invalids, almost any kind of milk that measures full 
quantity and is not sour passes as a first-class article, and 
is indorsed by the consumer as being perfectly reliable. The 
small amounts which adults consume, if they do not drink 
it as a food, are nearly always sterilized when added to tea 
or coffee or cooked into sauces, puddings, etc. ; conse- 
quently, milk taken in this way never produces any un- 
pleasant results. It is only the tender stomach of the infant 
or invalid, which is called upon to digest milk in large 
quantities, that is able to detect impurities or unsuitable pro- 
portions therein (149). 

110. There is a great difference in the actual quality of 
milk, not only in the amount of the ingredients therein, but 
in the character of those ingredients also. How can it be 
otherwise ? The dairyman will point out the great difference 
in the value of different animals in his herd, according to 
the amount of butter or fat which the milk carries and the 
amount of milk secreted daily. 

111. All milk should be as fresh as possible, but older 
milk may be used in cold weather and also in warm weather 
if kept continuously upon ice from the time it is drawn 
(564). It is not damaged by being frozen, so long as it 
has never been exposed to enough heat to allow it to thaw 
and the souring process to occur. This applies to the milk 
of the herd or the milk of the single cow. 

112. Great claims are made by all dealers regarding the 
quality of their milk and its suitability for infantile feeding ; 
but if the infant's digestion of it does not give comfortable 
results, it should be discarded and another milk tried. No 
milk is suitable if the cows are fed on brewery grains or 
waste products from a distillery or factory of any kind, and 
the fresh spring grass nearly always disturbs the quality of 



COW'S MILK 57 

milk for a week or two after the cows are first allowed to 
feed upon it. 

COW'S MILK 

113. As the health of the infant, perhaps even its life, 
depends upon the quality of the cow's milk upon which it is 
fed, it becomes very important that the selection of the cow, 
together with the food and care of the animal, should be 
carefully considered before commencing to feed its milk to 
the infant. 

114. As these animals are exposed to the inclemency of 
the weather at different seasons of the year, it is always 
desirable to select one of a strong, hardy nature and of a 
quiet disposition. Just as children are sickened by the dis- 
turbances in the health of the mother, so will they be sick- 
ened by the disturbances in the health of a cow which feeds 
them. 

115. Cows which usually give very rich milk are not so 
well suited for infantile feeding. This will exclude Jersey 
cattle, many thoroughbred animals and those which have 
not been born and raised in that climate (571). Usually, 
the Holstein, Ayrshire and common-grade cows are vigor- 
ous, healthy, strong stock, and secrete a milk suitable for 
infantile feeding. 

116. Experience shows that cows, when stabled and fed 
a fixed ration of clover hay with a moderate amount of bran 
and middlings, give a more equable and suitable quality of 
milk than do these same animals during the summer season, 
when they are allowed to roam the fields and feed upon 
variable kinds of grass which appear during the wet and 
dry weathers, from early spring until the late fall. Extraor- 
dinary amounts of green food, such as corn, young oats 
and very fresh grass, make a laxative and colicky quality of 



58 FEEDING RULES FOR INFANTS 

milk. It matters not whether dry feeding be done in win- 
ter or summer, the result is always better than when the 
cows are allowed to roam upon pasture fields. 

117. Milking should be done in a clean room and not 
in a foul, dirty stable. The udder should be thoroughly 
brushed before milking and the hands of the milkman, also, 
thoroughly cleansed. Milk should be drawn into a clean 
pail covered with two or three layers of cheese cloth, so that 
no particles of dirt can fall therein. In this way, all dirt will 
be strained out while passing through the cloth. As the 
milk ducts always contain some bacteria, the first few 
streams, which contain them, should be thrown aside. This 
reduces, very materially, the number of souring bacteria 
which appear in milk. 

HOW TO SEPARATE CREAM FROM MILK 

118. Great advantages are obtained in cooling milk by 
quickly changing it from the warm to the cold condition. 
The more marked and decided this change can be, the more 
perfectly will the cream rise to the surface. Milk, at a tem- 
perature of 60 degrees, when subjected to the influence of 
ice, will not throw up cream or fat as rapidly as the same 
milk would do if the ice were applied thereto when the tem- 
perature was at 100 degrees. It is often very much better, 
when wishing to hurry the separation of the cream, to 
warm the milk up to about 100 degrees, the natural animal 
heat, and then apply the ice while at this temperature. Of 
course, cream will always rise just in proportion to the 
intensity of the cold, and the warming and cooling should 
always be done rapidly to avoid souring changes which 
occur in milk at intermediate temperatures. 

119. By placing milk on ice, cream, being the lighter 



HOW TO SEPARATE CREAM FROM MILK 50 

substance, separates from the skim-milk and rises to the 
surface. The rapidity with which the cream and skim-milk 
are separated depends upon the amount of ice which sur- 
rounds them. Where it is used in abundance and the tem- 
perature of the milk quickly reduced below 40, the cream 
separates in from two to four hours. Where this low tem- 
perature is not obtained, it will require from twelve to 
twenty-four hours, or even longer, for all the cream to rise 
(559). 

120. By thus cooling milk, cream (fat) and skim-milk 
(proteids) are separated enough to answer all purposes nec- 
essary in infantile feeding. 

121. It is impossible to separate all the cream by the 
gravity process, but usually it can be done perfectly enough 
to suit the digestion of any infant. 

122. As all milk sours quickly when kept warm after 
being drawn, the milk pail should be immediately placed 
in cold water or the milk run over cooling pipes containing 
cold or ice water. As soon as the milk is cool, it should be 
bottled and kept on ice continually until it is fed to the 
infant; but where ice is not used, it will be necessary to 
carefully regulate the number of hours which it must stand 
in a cellar or other cool place before being prepared for 
food, in order to remove a portion, at least, of the cream 
(564). 

123. Where cream is thus raised from milk without ice, 
it will be requisite to pasteurize, or even sterilize, the milk 
and cream, as soon as they are separated from each other, 
so as to destroy the bacteria, and thus prevent souring. 
This is always necessary in hot weather (147). 

124. The fat globules in milk make a decided difference 
in its suitability for infantile feeding. Where those globules 



60 FEEDING RULES FOR INFANTS 

are very large, they respond quickly to the influence of cold 
and rise to the surface in a few hours; but where they are 
very small and fine, they are exceedingly numerous and do 
not respond to the cold so rapidly. The result is that there 
is ,a great difference in the perfectness with which cream 
can be separated, and this causes one of the main difficulties 
in feeding infants. While this difference may not be of 
importance in feeding healthy, strong babies with good 
digestion, it very commonly offers a serious obstacle in feed- 
ing very delicate or damaged ones. This frequently is the 
case where fat cannot be digested well. 

125. From the above facts, it will be seen that any 
method which does not separate cream entirely cannot be 
used for infants whose power to digest fat has been de- 
stroyed or badly impaired by overfeeding this food at some 
previous date. Some mothers become very expert in hand- 
ling milk used for their infants by finding the number of 
hours which it requires to stand in a cold place, when ice 
is not used, in order to remove the surplus of cream which 
their infants cannot digest. These mothers feed the sugar 
solution (206) and skim-milk thus prepared, varying the 
digestibility of the food by the length of time the milk stands 
before being added to the sugar mixture. In this way, they 
adjust the necessary fat and proteids in fresh milk and thus 
secure well-digested and formed stools (560). 

126. In large establishments, cream is removed from 
milk by separators, which do this work very rapidly and 
perfectly, without the aid of ice. This method secures milk 
and cream in the newest and freshest condition. It also 
removes all dirt in the milk ; but this method cannot be used 
except on large amounts of milk. 



VARYING AMOUNTS OF CREAM IN MILK 61 

. WHOLE MILK VS. SKIM-MILK 

127. By whole milk, we mean the milk with all the cream 
retained in it. By skim-milk, we mean the milk left after 
the cream has been removed. 

128. Skim-milk may contain any percentage of fat, less 
than the natural amount, according to its age and the tem- 
perature to which it has been exposed while standing (118). 
Where an abundance of ice is used and the milk chilled 
down after it is drawn, no souring occurs for a day or two, 
according to the season of the year; consequently, skim- 
milk thus kept is suitable for infantile food. 

129. Whole milk, when well diluted, may be used for 
feeding some infants where they can digest the natural pro- 
portion of fat which it carries ; but infants whose digestive 
organs have been damaged by overfeeding fat, very seldom 
can digest the amount of this food contained in whole milk. 
With these infants, it is necessary that skim-milk be used in 
preparing their food, and only that proportion of fat or 
cream added which the infant can properly digest. Many 
infants, who have been abused by overfeeding of cream, 
entirely lose the power to digest this food, but usually 
recover it in a few weeks, if properly fed. 

VARYING AMOUNTS OF CREAM IN MILK 

130. Great variations in the strength of milk are shown 
by analyses of many samples of milk. The author is in- 
debted to Tower's Wayne County Creamery, in Detroit, for 
the privilege of using one of their record books, showing 
their analyses of farm milks. This firm has, for years, kept 
a system of the latest milk analyses, whereby they ascertain 
exactly the percentages of fat every day on all milk shipped 
to them from several hundred farms within a short radius 



62 



FEEDING RULES FOR INFANTS 



of Detroit. Out of this large number, we have selected two 
farms which represent the highest and lowest percentages 
of cream on farmer's milk. By their system, Towar's 
Wayne County Creamery collects samples every day, and 
the following figures represent the monthly averages of 
cream from the milk thus collected. It will be seen that 
each sample varies continually from month to month, but 
each one consistently maintains its highest or lowest aver- 
age, thus showing that the grade of cattle and the feeding 
thereof has been consistent throughout. 

131. TABLE OF CREAM AVERAGES 



THE 


HIGHEST 


THE LOWEST 


AVERAGE OF CREAM 


AVERAGE OF CREAM 


4.00 


per cent 


3.60 per cent. 


4.10 


« 


3.50 


3.80 


« 


3.40 


3.90 


u 


2.80 


4.00 


u 


3.20 


4.00 


tt 


3.50 


4.30 


it 


3.40 


4.20 


it 


3.60 


4.00 


ft 


3,40 


4.10 


tt 


3.70 


4.50 


it 


3.80 


4.70 


tt 


3.80 



January . . . 
February. . 

March 

April 

May 

June 

July 

August. . . . 
September 
October. . . 
November 
December. 



VARIATIONS IN THE STRENGTH OF MILK 

132. This is a very important subject to thoroughly 
understand when using cow's milk for infantile feeding. 
To the kindness of Dr. Towar, of Towar's Wayne County 
Creamery, the author is indebted for the following chart. 
It shows the percentage of each* food and also the total 
foods, or solids, and water in the milk of six cows selected 
out of their herd of 117 kept on their farm near Ann 
Arbor. This herd supplies only their certified grades of 
milk and is always fed on a fixed ration. At my request, 
he took the milk from Jersey and Holstein cows only, as 



VARIATIONS IN THE STRENGTH OF MILK 



63 



they can fairly represent the milking extremes of quantity 
and quality. 







d 






.5 


.s 


c 




Q 
















8*8 


'53 

4-* 


>» 


>> 




'S 


D 




01 


u 


a> 


(A 


CO 


en 






Ml 


(A 










"o 


Ih 


Ih 


"o 


*o 


O 






ffi 


•— > 


O 


E 


HI 


ffi 




w w 
















o 


CM 


o 


iO 


o 


o 




HU 


t~ 


iO 


*o 


CO 


00 


?o 




^ a, 


00 


S 


00 


00 


00 


38 




H 
















•JwJZ 
















r (i, y 
0* 


o 


CM 


o 


iO 


© 


o 




CO 


i— t 


o 


<o 


CM 


"^ 




oi 


xo 


id 


CM 


CM 


t— i 




r-i 


r- 1 


" 


'""' 


" 


T— 1 




w H 
















Q .;Z 
















ROTEI 
AND 

SUGAS 
ERCE 


O 


CM 


o 


iO 


o 


o 




O 


iO 


T— I 


1—1 


t~ 


o 




o> 


O 

T— ( 


© 

T— ( 


oi 


00 


aS 




eu b 
















H 
















.2 
















hH 


o 


o 


o 


o 


o 


o 




< u 


CO 


«o 


T 


iO 


iO 


-^ 




hrt 
M 


CO 


^ 


id 


CO 


CO 


CM 


















o 


-o 


T3 


*o 


*0 


*o 


-a 




> 


o 


O 


o 


o 


o 


o 




< 


o 


O 


o 


o 


o 


o 




J 


o 


a 


O 


o 


O 


O 






_ 


, 


, 


, 


l , 


t 




w 


cfl 


rt 


rt 


rt 


CO 


rt 




H 


s 


a 


& 


a 


a 


E 




(0 

< 


N 


u 


i* 


Ih 


14 


Ih 




o 


o 


O 


o 


o 


o 




fc 


£ 


£ 


£ 


£ 


£ 




.H 


















-**• 


© 


CM 


(M 


■^f 






MM 


r-l 


<M 


CM 


T— t 


r-( 






ow 
















a, 
































TIME 
SINCE 
RAWN 

HRS. 


^ 


"* 


^ 


•^ 


^ 


^ 




i—l 


i— ( 


1— 1 


rH 


^ 


T ~ l 























O 


© 


o 


^ 


© 






o 


00 


00 


00 


00 






(4 


?o 


iO 


*o 


iO 


- iO 






H O 


o 

CO 


tH 


00 


00 


(M 


d 




< OS 


i-H 




tH 


CM 




a ■* 


1) 


^J 


•*-» 


+J 


+1 


*■• 






o 


o 


«J 


O 


y 






o 


o 


o 


o 


o 



64 FEEDING RULES FOR INFANTS 

134. All the samples of milk used in these analyses are 
fourteen hours old and tested at nearly the same tempera- 
tures. The main point to be noted is the great variation 
that exists in the amount of the foods or total solids in 
the different milks. This varies from 15J per cent, in the 
richest to llf per cent, in the weakest samples. A 
greater contrast is shown in the proportion of fat. This 
ranges from 5f per cent, in the best Jersey to less than 
half that amount, 2f per cent, in the most dilute sam- 
ples of Holstein. 

135. The remaining solids, which are the sugar and 
proteids, show a corresponding, though not so decided, 
variation in amount, ranging from 10 J per cent, in the 
best Jersey to 8| per cent, in the weakest Holstein. 

136. A glance at the water shows the greater amount 
which is present in poor milk. This is, of course, neces- 
sary to compensate for the reduced amount of solids. 

137. When we look at the great variations in the total 
foods and remember that they are all the food which milk 
contains, we realize at once how important it is to have 
the same grade of milk every day when feeding an infant. 
We can also see how children will vary in the amount of 
milk they must drmk daily, when they are taking different 
milks, in order to be equally well nourished. An infant 
who consumed twenty ounces daily of the best Jersey milk 
in the above chart would require to take nearly twenty-six 
ounces of the weakest Holstein each day to be as well 
nourished. 

138. We must not conclude from the above facts that 
the Jersey milk is superior to the Holstein as an infantile 
food. The experience of most physicians who are con- 
versant with this subject is that the Holstein milk makes 



MILK AS A DRINK 65 

the better food ; but this is not yet a settled fact. This 
claim is made largely on account of the greater strength, 
more rugged health and quieter temper of the Holstein 
cattle. These qualities secure a milk of a less variable 
quality than can usually be obtained from the more nervous 
and delicate Jersey. 

139. While the above chart shows the Holstein milks to 
be much lower in food percentages than the Jersey samples, 
we must not conclude that this always applies. Dairymen 
commonly find striking exceptions to this rule. The lesson 
to be learned is that the amount of milk fed to infants must 
vary according to the richness of the milk, as this richness 
always represents the amounts of fat, proteids and sugar 
which the milk carries. 

MILK AS A DRINK 

140. Very commonly, a mother will give her infant milk 
to drink when she thinks it is thirsty. This occurs at all 
seasons of the year, but most frequently during the sum- 
mer-time. A little thought on her part should prevent her 
from doing this. 

141. During hot weather, especially, infants become 
fretful and uneasy, even when they are fed regularly and 
given full amounts of food. This is mostly due to the heat 
and consequent thirst. Here is an instance where the 
mother unconsciously denies her infant the privilege she 
demands for herself — that of taking water alone, rather 
than meat or bread with water, when she wishes to quench 
her thirst. 

When an infant is thirsty and cries for a drink, instead 
of giving it water, as the mother should do, she gives it 
milk, which is equal to the water she takes herself with 

6 



66 FEEDING RULES FOR INFANTS 

meat and other foods added thereto. A mother must re- 
member that milk is not a drink alone, but it is a drink and 
food combined, and as she would herself be very soon sick- 
ened on a hot day by eating large amounts of solid food 
every time she took a drink of water, so must the little one 
be sickened when she insists upon its taking a drink and 
solid food together as it exists in milk, instead of that 
water alone for which it craves so much. 

142. All mothers should bear in mind that they can only 
feed an infant the same amount of food each day, but they 
can increase the drink just in proportion as the increased 
heat of the season makes it necessary. Increased drinks 
never do any harm, but increased food always results in 
sickness, just in proportion as the food has been unduly and 
thoughtlessly given (279). 

143. There is no cause so certain to produce sickness as 
unsuitable increases in the child's food, and this is always 
the case when milk is given as a drink. Rather than give 
milk as a drink to the infant on a hot day, the mother 
should reduce the regular amount of milk in direct propor- 
tion with the increased heat, for by doing so she will gen- 
erally avoid those summer bowel disturbances which are 
so fatal. All adults demand less and lighter food as the 
hot weather approaches, and all infants require the same 
decrease in order to remain in good health. 

SOURING OF MILK 

144. It is necessary to keep milk en ice in order to pre- 
vent souring or fermentation of the sugar therein. This is 
easily done during winter weather, but in the warmer sea- 
son this change occurs so rapidly that it must be either 
pasteurized (145) or sterilized (148), to avoid indigestion 



PASTEURIZATION OF MILK 67 

and consequent bowel disturbances in the infant. Where 
this tendency shows in the child, the milk should always be 
boiled; bottled while hot; the meals put up separately; 
corked with cotton batting and placed upon ice until used. 
This process prevents all contact with souring bacteria after 
the food is prepared (209). 

PASTEURIZATION OF MILK 

145. This is a term applied to that process of heating 
milk which is sufficient to destroy most of the injurious 
bacteria therein *and still preserve its natural taste. To pas- 
teurize milk means to raise the temperature to about 170 
degrees and retain it at that point from twenty to thirty 
minutes. There are cans for this purpose, into which a 
thermometer is fixed so that the temperature can be read 
while the work is being done. A simple way of effecting 
this result is to place the milk in a bottle and set it in a tin 
pail of cold water, deep enough to surround the milk en- 
tirely. This cold water should then be boiled for half an 
hour. Care should be taken to place a plate or dish under- 
neath the bottle to prevent it from being broken by the 
heat. 

146. This process of pasteurization may not be neces- 
sary with good healthy, clean milk in the winter season, 
but it is absolutely essential during the hot months of sum- 
mer, as the souring bacteria in milk work so rapidly in 
warm weather that it is seldom safe to use milk in its raw 
condition at that season of the year. These souring bac- 
teria are so antagonistic to the peptonizing process in the 
stomach that only very strong, healthy children are able to 
use milk in its raw state. Even in cold weather, particularly 
in cities where milk is kept a long time before being deliv- 



68 FEEDING RULES FOR INFANTS 

cred to the consumer, it is frequently necessary to pasteur- 
ize it when used for infantile food. 

117. As cream does not rise from pasteurized milk, it 
is always necessary to separate cream from skim-milk 
before pasteurizing both of them. Pasteurization checks 
the changes in the sugar. It has no effect upon the fat; 
but, inasmuch as the cream carries a percentage of sugar 
also, itjs necessary that both should be pasteurized. 

STERILIZATION OF MILK 

148. This process means simply bringing the milk to a 
boiling point and retaining it there for twenty minutes or 
half an hour. As sterilization changes the taste of milk 
and renders it less palatable, it is, consequently, a less desir- 
able treatment than pasteurization, though a more perfect 
one. Where it is inconvenient or unsuitable to pasteurize, 
sterilization can be adopted. The same necessity arises for 
separating cream from skim-milk before sterilizing as 
exists before pasteurizing. Sterilization may be done by 
putting the milk directly on the fire and boiling it, or car- 
rying on the pasteurizing process for a time long enough 
to make the milk boil. The latter is the better process. 

149. As there is uncertainty about the pureness in char- 
acter of any milk (109), it is always desirable, when a 
child shows bowel disturbances, to pasteurize or sterilize it 
for a few days, in order to ascertain whether this difficulty 
in the digestion arises from changes which occur in the 
milk or is due to the size of the meals. 

PEPTONIZATION OF MILK 

150. As cow's milk carries a much higher percentage of 
casein proteid than human milk, and as this is the most diffi- 
cult one to digest, infants very commonly suffer from food 



PEPTONIZATION OF MILK 69 

fermentation or decomposition, with consequent gas, colic, 
disturbed sleep and loose, green, mucous stools while taking 
this food (281). 

151. Young infants with feeble digestive power and 
others whose digestive glands have been damaged by over- 
feeding of fats, proteids or sugar are unable to digest cow's 
milk in proportions large enough to nourish them properly 
unless the proteids therein are partially predigested. 

The observations and work of Drs. Van Slyke and Hart 
in the feeding of calves at the New York Agricultural Ex- 
periment Station have aided physicians greatly in system- 
atizing the process of predigesting cow's milk for infantile 
feeding. While the changes produced on milk by rennet, 
acid, pepsin and pancreatin have long been known, the sys- 
tematic order of using them has not been recognized hitherto, 
and the writer fully appreciates the benefits resulting from- 
their clear description of the several steps necessary to 
follow in order to secure successful results. 

152. In the digestion of proteids, nature makes three 
different successsive changes in the stomach, and this re- 
quires three different sets of glands in that organ. The 
first change is affected by the rennet secretions, the second 
by the hydrochloric acid and the third by pepsin, and all 
three are necessary for perfect work. 

As the amount of casein in human milk is much less than 
in cow's milk, it is natural that the proteid digestive se- 
cretions of the infant should be inadequate to digest cow's 
milk. This being the case, does it not seem reasonable, and 
in most cases absolutely necessary, to assist the infant in 
this process of digestion? The experience of the writer has 
convinced him that it is a mistake to put this heavy labor 
on the feeble digestive glands of many infants without 



70 FEEDING RULES FOR INFANTS 

rendering them this assistance. Objection is raised to this 
digestive assistance by many physicians on the ground that 
predigesting milk lessens the labor of the infant's digestive 
organs, and, consequently, weakens them by non-use. For 
many years the writer believed in this principle and acted 
upon it and thus caused a great deal of suffering and distress 
amongst his patients. For the last five years, the milk fed 
to all infants has been predigested whenever an infant has 
shown inability to do this work perfectly and be happy and 
comfortable while so doing. Very many of these infants 
have been fed for several months in succession upon pre- 
digested milk and always with great benefit. There has 
never appeared one case which showed any decrease of sub- 
sequent digestive power on this account, but, on the con- 
trary, all have shown- greater growth, happiness and im- 
provement from every point of view while taking predigested 
milk, and, invariably, they have been able, in a few weeks 
or months, to take stronger milk preparations and digest 
them perfectly without any artificial assistance. 

Predigestion of milk has been commonly called peptoniza- 
tion. This word is a misnomer, as there is no pepsin used 
in the process. The pancreatin used for this peptonizing 
process is useless unless it is in an alkaline medium, conse- 
quently, a large amount of bicarbonate of soda is necessary 
to produce this alkalinity and thus render the pancreatin 
effective. This method ignores the work of the stomach, 
as the rennet, acid and pepsin work only in an acid medium, 
which is the natural condition of the stomach, consequently, 
neither lime-water nor soda can be added where rennet is 
used for predigesting cow's milk. 

Failure to digest cow's milk in the infantile stomach may 
be due to a deficiency in any one of the stomach secretions 



PEPTONIZATION OF MILK 71 

— rennet, acid or pepsin — and these secretions act in the 
order above named. Before deciding to pancreatize milk in 
the alkaline medium suitable to the upper bowel, proper 
efforts should be made first to artificially coagulate the milk 
with the rennet solution and thus digest it partly in the 
stomach, as nature intended. This demands that the milk 
be first pasteurized for half an hour in order to destroy 
lactic acid or souring bacteria, as pepsin will not act where 
many of these are present. This is done by putting pure 
milk (not diluted) in a bottle and setting it in cold water 
which must be boiled for half an hour. When this water 
gradually cools to 104°, the rennet should be added to the 
milk, still standing in the water, and also a small pinch of 
common salt. If there is enough rennet used, coagulation 
will be accomplished in a few minutes and then the whole 
amount should be vigorously shaken to thoroughly break up 
the curds. When all is thoroughly rennetized or coagu- 
lated, it can be diluted, sweetened and fed. The amount of 
salt needed in this solution is very small, being only enough 
to be tasted in the solution. This rennetized or coagulated 
milk can be placed upon ice and kept for subsequent meals. 
Care must always be taken to heat it slowly in water of 
about 103° to 105°, as quick heating renders the curds diffi- 
cult to digest. 

It must be borne in mind that this whole process of ren- 
netizing is following nature's work in the calf's stomach, 
and, to be successful, it must be conducted upon nature's 
principles of temperature. Rennet is obtained from the 
calf's stomach, and a great many infants, when receiving 
this natural rennet assistance to digest that milk, which is 
intended by nature to be digested only in the stomach of that 
animal, will be able to finish the process successfully and 



72 FEEDING RULES FOR INFANTS 

thus become happy and thrive satisfactorily, but would fail 
entirely to do so without this assistance. As this is the first 
process in the act of digestion, it should always receive a 
fair trial before resorting to the later process of pancrea- 
tizing the milk, as has been commonly used hitherto. Pan- 
creatin only works below the stomach and thus entirely cuts 
out the work of this organ. 

The amount of salt added to this solution supplies a por- 
tion of hydrochloric acid which assists the natural secretions 
of the stomach to dissolve these curds, and, in some cases, 
where it may appear necessary, small amounts of pepsin 
in a hydrochloric acid solution may be given to the infant 
after feeding to assist in digesting the rennetized curds be- 
fore they pass out of the stomach. Where these agents fail 
in making the infant happy and grow satisfactorily, the 
pancreatin and bicarbonate of soda solution should be tried. 

Peptonizing (pancreatizing) tubes can be procured with 
full instructions for doing this work from any reliable 
druggist. 

153. Some recommend peptonizing (pancreatizing) by 
the cold process and others by the warm one. As milks 
differ according to age and quality, they sometimes present 
difficulties when being peptonized (pancreatized) in large 
quantities for the whole day's dietary. It is always best to 
add just sufficient pancreatin powder, mixed with sugar, 
for a meal before warming the milk for feeding. In this 
way the process commences with heating the food and con- 
tinues after feeding. 

154. Peptonization (pancreatizing), when carried too far, 
renders milk very bitter and objectionable to most infants. 
As this process requires body heat for its success, care 
should be taken to feed the milk as soon as it is warm 



CONDENSED MILK 73 

enough, and not allow any delay of the infant in taking it, 
as it will coagulate and become bitter when kept too long 
while being fed. 

155. Where mothers try to peptonize (pancreatize) the 
whole amount of food for the day, they very commonly, 
have difficulty in preventing the process going too far. This 
is avoided by preparing and feeding it as above directed. 
When the warm process is followed and the milk boiled 
to check farther peptonization, the continued good effects 
of peptonizing are lost to the infant. The most convenient 
way is to have the peptonizing (pancreatizing) powder 
made into a mixture so that it can be added to the food 
when being warmed. 

156. The following mixture keeps well and is convenient 
to use. It should be kept as cold as possible. 

Pancreatin, 1 drachm; salicylate of soda, 5 grains; bicar- 
bonate of soda, 80 grains; simple syrup, 4 ounces. 

By this plan, ten to twelve drops will peptonize one ounce 
of milk, and enough of it should be put into each bottle 
before warming the food to peptonize or predigest the 
amount of milk which each meal contains. It can be in- 
creased when needed. 

When a pancreatin mixture smells very strong and dis- 
agreeable, it shows that there is some decomposition in it 
and the pancreatin of some other manufacturer should be 
used. 

CONDENSED MILK 

157. Condensed milk is a valuable food in the following 
conditions: 1st — Where a reliable and pure cow's milk 
cannot be obtained. 

2d — During hot weather, in families who have not an 
abundance of ice to prevent the souring of cow's milk. 



74 FEEDING RULES FOR INFANTS 

3d — While traveling, in order to avoid the danger from 
changes in cow's milk when kept too long. 

158. The addition of sugar in making condensed milk 
prevents all changes which are caused by age and heat on 
fresh milk; but the very high percentage of sugar necessarily 
compels the infant to receive more of this food than nature 
intended. This being the case, it is an impossibility to feed 
the full amount of proteids needed for infantile food, as the 
proportions of this food to the sugar is much less than is 
present in either human or cow's milk. Children fed in this 
way become very fat, white and sluggish. They present a 
good appearance, usually, but are generally slow in teething 
and walking, and have not that resistance to sickness which 
children enjoy who are fed upon a more natural proportion 
of fat, proteids and sugar. 

159. In hot weather, condensed milk, very commonly, 
becomes valuable as a substitute for cow's milk and if not 
fed too liberally, will often carry a delicate infant success- 
fully through the trying weeks of summer. One very great 
objection to its use is the impossibity of adding enough 
starches to the dietary while feeding such a high percent- 
age of sugar. This feature prevents the changes in 
food necessary for the child's development until the in- 
fant is beyond the age when starch should have been intro- 
duced. 

160. There is not much difference in the various brands 
of condensed milk. The main one is that some carry a little 
more sugar and fat than others. Some manufacturers re- 
move the cream and condense the skim milk, and others 
make additions to condensed milk which they specify upon 
their labels, and upon these additions make specific claims 
for excellence. As with cow's milk, so it is with condensed 



EVAPORATED CREAM 75 

milk — that brand which gives healthy stools and makes the 
child happy is the one suitable for that particular infant. 

EVAPORATED CREAM 

161. This is a condensed milk, made. by evaporating part 
of the water from the milk and sealing it in tin cans while 
hot: Manufacturers depend upon its complete sterilization 
to preserve it from decomposing. No sugar is added to 
assist in its preservation. It is unlike condensed milk, in- 
asmuch as it is subject to the same changes as cow's milk 
when exposed to the air. Evaporated cream is a very 
valuable food where it is impossible to obtain a good reliable 
cow's milk, and is more valuable as a regular diet than 
condensed milk, as it allows the addition of starch at any age 
where an infant is able to digest it. 

162. Both evaporated cream and condensed milk are 
unsuitable as a constant diet on account of the complete 
sterilization to which both have been exposed. Infants 
fed on these foods are very liable to have scurvy unless 
some other food, such as beef juice or orange juice, is given 
in addition thereto. 

163. Where an infant cannot digest fat, it may be im- 
possible to feed evaporated cream, as the fat cannot be re- 
moved from any milk which has been sterilized. 



CHAPTER VI 
SUBSTITUTE FOODS AND FEEDING 

164. Many infants require hand-feeding from the day of 
their birth, while others may require it at any age before the 
natural time for weaning. This necessity is imposed upon 
infants under three conditions: 

1st — Where a mother has no milk secretion. 

2d — Where her milk, though good, is insufficient to 
properly nourish the child (48). 

3d — Where she has an unhealthy supply that sickens the 
infant(48). 

All these conditions are liable to occur at any time during 
the nursing period. It becomes necessary, then, to 
thoroughly understand how to adjust artificial or new food 
to the varying conditions of the digestive power of young 
infants during the first year of their lives (276). 

The second and third classes are treated under "Imperfect 
Nursing Which Demands Hand-feeding" (99 and 573-579). 

165. As the digestive glands of the young infant are 
continually growing more numerous and stronger, it can 
easily be seen that its powers of digestion are steadily 
increasing. This healthy change in the digestive glands to 
increasing capacity is always entirely dependent upon the 
perfect digestion of fat, proteids and sugar and the conse- 
quent successful growth and development of the child's 
digestive power (187 ). 

166. In accordance with these conditions, artificial or 
hand-fed infants can be divided into two large classes: 

76 



SUBSTITUTE FOODS AND FEEDING 77 

The first class comprises those who have been properly 
fed, whose digestive glands have never been injured, whose 
growth and development is a continual success and who 
have the foundation laid for future good health, strength and 
probable success in life. Their diet has been similar to that 
shown in schedules 573-579. 

The second class, and I am forced to say it is a very large 
cne, comprises those improperly fed infants who manage to 
exist and grow, though imperfectly, in spite of the abuse 
rather than the proper use of their digestive power. The 
amount of damage done to these infants during the first few 
months of their lives depends, of course, upon the extent of 
errors committed in trying to feed an unsuitable diet (210). 

Some are crippled in this way one-eighth, others one- 
quarter and others even to one-half, in time reaching that 
point where there are not enough healthy digestive glands 
left to convert the amount of nourishment needed to sustain 
life. These are doomed to an early death. In a large 
number of hand-fed infants thus crippled by dietetic abuse, 
we find evidence of this damage done them in their reduced 
growth, smaller size, large heads, deformed bodies and limbs, 
enlarged livers, irritable, nervous constitutions, weak kid- 
neys, skin eruptions, poor color, lesser vitality and reduced 
power to resist the diseases of infancy (14-15). 

167. The proper feeding of these damaged infants is, 
generally, a very difficult problem and can only be properly 
done by the experienced physician. As an assistant to the 
mother, and also to show the difficulties and delays involved 
in this intricate work, the author is preparing a separate 
book called, "Feeding Rules for Delicate Infants," which is 
devoted entirely to this class of cases. In this volume, the 
filled schedules show the exact food and actual progress made 



78 FEEDING RULES FOR INFANTS 

by damaged infants. The great variety of these cases 
might call for an innumerable number of schedules, but the 
author has used only a sufficient number to illustrate the 
more frequent forms of dietary needed to correct and im- 
prove errors shown by this class of infants. 

WOMEN SUITABLE TO DO INFANT FEEDING 

168. It is not every mother, even when she is properly 
educated for this work, who should undertake the important 
duty of feeding her infant artificially. As her own rest, 
comfort, mental happiness and perhaps even her health may 
be involved in this labor, the question should always arise, 
Will I nurse my baby? Will I get a wet-nurse for it, or 
will I feed it by hand? Oriiy those who have had experi- 
ence in this work and have seen hand-feeding done by many 
mothers, are enabled to correctly form an opinion on this 
important matter. 

169. Where there is no possibility of avoiding hand-feed- 
ing, the mother who has this duty imposed upon her should 
be most careful to thoroughly inform herself on all matters 
pertaining to this work and not trust to luck in following 
*he advice of any or every woman who presumes, through 
density of ignorance, to give advice on this important sub- 
ject(186). 

170. Experience shows that young women who know 
nothing and presume to know nothing about hand-feeding, 
and consequently have no bad rules to unlearn, are the most 
successful. These young women with their first babies are 
commonly more independent thinkers, and being trained and 
educated to seek information from proper sources, they 
logically reason out the cause and result, mark out their 
own course and follow it independently of all suggestions 



WOMEN SUITABLE TO DO HAND-FEEDING 79 

from outsiders and only accept advice from the authority in 
whom they have confidence. It is this education and habit 
of an independent mode of thinking and acting which lays 
for them the foundation of their success. They seldom fail 
in raising strong, vigorous children, free from damage or 
the crippling effects of injudicious feeding. 

171. Women who are anxious to show large fat babies, 
and whose ambition it is to excel all their neighbors in 
the size of them, generally fail in hand-feeding. They are 
so intensely anxious to make their infants grow that they 
never can feed correctly; that is, according to the proofs 
which the child presents in the character of the stools (272). 
They invariable increase the food too much or too often, 
and make all sorts of excuses to themselves and their 
friends to explain the digestive disturbances shown in the 
stools (284). They always attribute these unfavorable 
results to teething or some other nonsensical reason from 
the time the child commences drooling at three months, until 
it is two or three years old. 

WOMEN SUITABLE TO DO HAND-FEEDING 

172. Mothers who have nursed previous children success- 
fully, but who are now compelled to wean the infant while it 
is under six months of age through inability to nurse it, 
seldom feed successfully until after they have made such 
errors that the infant's growth is hindered or its life greatly 
endangered, and only from the dread of the future and 
proofs of past errors do they exercise that stability, 
patience and careful thought which are necessary to bring a 
damaged child out of its precarious condition. Months of 
anxiety, worry and broken rest are always before those ma- 
tured but inexperienced mothers in this unfortunate position. 



80 FEEDING RULES FOR INFANTS 

173. From the above it will be seen that only one 
head can direct all changes in the feeding of a young 
infant (167). Where the mother's duties are such that she 
cannot give that continued time and attention which are al- 
ways necessary for success, this work should be relegated to 
some reliable, intelligent nurse who must be characterized 
by the same qualities necessary in the young mother. She 
must be entirely free from all advices of outsiders, free from 
all preconceived ideas of right and wrong feeding, a good 
careful thinker, free from all prejudices for or against all 
kinds of food; patient, healthy, industrious and reliable. 
There are not many of these nurses to be obtained in any 
community, but there are always a few, and any young 
woman who is healthy, intelligent, and willing and who 
knows nothing at all about feeding an infant, will be sure 
to succeed with a good teacher or book if allowed to con- 
tinue in full charge of the food and feeding, being only 
judged by the good results which she produces in the ap- 
pearance of the infant, its happiness, steady growth and 
development (202). Where such a nurse realizes that 
healthy formed stools, free from foul odors, are proof of 
perfect digestion, and that this condition always guarantees 
future success, her labor is easy, and the infant's future 
growth is assured, if she maintains this condition. 

IGNORANCE AND INEXPERIENCE 

174. The mother or nurse who has raised other babies, 
well or poorly, and who has a strong, preconceived idea of 
what foods to use and how to feed an infant; in other words, 
who thinks she knows enough about this subject, is almost 
sure to overfeed and thus damage the child. A nurse 
should never be employed unless she be one who is intelligent 



IGNORANCE AND INEXPERIENCE 81 

and industrious, but entirely ignorant of this subject, or 
one who has been previously thoroughly trained by some 
reliable physician how to guide all her advances and changes 
in food by the character of the digestion, as shown in the 
stools. The nurse or mother who has gone through this, 
who has raised one or more infants in this particular way, 
realizes the importance of this work and never makes sug- 
gestions about any food to an anxious, worried mother. 
Her experience has been such that she is thoroughly com- 
petent to realize fully that no one can intelligently give ad- 
vice upon this subject who is not thoroughly conversant 
with the digestive power of the infant, its previous dietary 
and the mistakes made in feeding it. Without experience 
and this knowledge, it is impossible for any nurse, mother, 
or physician to speak intelligently on any particular case, 
and those who presume to do it, though meaning it in kind- 
ness and good will for the little one, would certainly not do 
so if they realized how thoroughly ignorant they are of the 
present necessities of each case. They do not know enough 
about this subject to know that they know nothing about it. 
They presume to give advice, thus illustrating that passage 
in scripture which says, "Fools rush in where angels fear 
to tread." 

175. Physicians, experienced on this subject, give more 
thought, care and study to each infant whom they are feed- 
ing than they do to attacks of sickness of any kind which 
they are called upon to treat. In sickness, patients usually 
travel along lines common to the disease, and consequently, 
do not present one-tenth part of the various changes which 
occur in the intestinal tract of the improperly hand-fed 
infant. At each and every visit, a detailed account of the 
child's progress must be examined carefully from all points 

6 



82 FEEDING RULES FOR INFANTS 

of view before the physician feels safe in giving any advice 
regarding future changes which may be necessary in the 
infant's dietary. How, then, can any person, who is not 
well versed in this work and who has not had the necessary 
experience in feeding a great many children, presume to 
give directions where the child's health and even life may be 
endangered by such advice? 

176. Mothers and nurses, who have had this experience, 
know and feel that the only sure and safe way for the 
mother is to get her directions from some one competent to 
give them, the same as they themselves were compelled to 
do, and the only one who should be competent to direct is 
the one who does this wdrk most frequently, and that is the 
family physician (167). 

THE IMPORTANCE OF PROPER DIET DURING THE 
FIRST YEAR 

177. Very few people, excepting those who are making 
vital statistics in the health offices of the different cities and 
states of our country, have any conception of the number 
of deaths occurring among children at different ages in the 
cities and country districts. They, likewise, have little 
knowledge of the causes producing these various diseases 
from which so many of our children die. Aside from our 
own anxiety, we are all educated by our Daily Press and the 
necessities of business to hold in great dread the approach 
of all epidemics of contagious diseases, such as scarlet fever, 
measles, diphtheria, whooping-cough, smallpox, typhoid 
fever, etc. When an epidemic of any of those diseases breaks 
out in any city, town or village, the newspapers im- 
mediately advertise the fact and our health officers set to 
work with all diligence to placard the houses where the 



THE IMPORTANCE OF FIRST YEAR DIET 83 

diseases exist and thus prevent the spreading thereof. 
These precautions are all correct and as they should be. 
We are careful regarding these diseases because we are edu- 
cated to the importance thereof. We all do this to save the 
lives of our children and to avoid sickness, with the conse- 
quent worry and anxiety which always accompany these at- 
tacks, no matter how slight they may be. From these 
epidemic diseases, yearly, we have a great many deaths and 
it is the fear and great dread of these deaths that makes us 
so nervous, cautious and anxious to do everything possible 
to protect our children from them. 

178. Let us look, for a moment at the position we occupy 
as intelligent, progressive American people, on the very im- 
portant subject of diseases and the care of our children. To 
illustrate this, we will take the vital statistics of the state of 
Michigan for the year of 1900. In this year, the number 
of deaths from all epidemic diseases is shown for the different 
months. Those statistics also show the number of deaths 
among children during the first year. 

179. It is a well-recognized fact among physicians that 
two-thirds of all deaths of infants during the first year are 
the direct result of improper feeding. It is the writer's 
desire and object to show parents the exact position in which 
they stand regarding the care of their children from the 
day they are born until they are thirty years old, and also 
their mortality. 

180. The following Michigan statistics for the year 1900 
will illustrate our subject. They show the number of 
deaths in the whole state, cities and country included, of 
all children during the first year and also the number of 
deaths from the different diseases during all ages. 

181. In that year there were 6,542 deaths of infants 



S4 FEEDING RULES FOR INFANTS 

under one year old. These figures do not include the num- 
ber of children that were still-born. 

182. During that same year the number of people of all 
ages dying from the following epidemic diseases: typhoid 
fever, diphtheria, croup, scarlet fever, measles, whooping- 
cough, and cerebro-spinal meningitis, was 2,571. These 
figures show that two and a half times more individuals die 
during the first years of their lives than from these conta- 
gious diseases at any and all ages. If we allow one-third of 
the deaths during the first year to be caused by diseases 
other than those that result from digestive disturbances, we 
then have 4,362 children under one year old dying from 
digestive disturbances every year against 2,571 individuals 
of all ages dying from those epidemic diseases which our 
health laws spend so much time and money to prevent. 

183. If we look at the mortality statistics of the' city of 
Detroit for the fiscal year ending June 30, 1903, we find that 
there were 1,187 deaths among infants during the first year 
and 1,167 deaths of individuals from all diseases between 
one and thirty years. Here, again, we have a startling 
evidence of the relative mortality of our population mostly 
from food errors during the first year and from all causes 
during the next twenty-nine. 

184. If, as the experience of physicians shows, two-thirds 
of these 1,187 infants, who were lost during the first year, 
died from digestive disturbances, it proves that there are no 
diseases, accidents or combinations thereof which produce 
such an immense mortality as do these errors which we are 
committing daily in the feeding of our little ones; yet, this 
occurs continually and we continue to repeat the same 
errors, which are the direct result of our ignorance on this 
all important subject. Surely, nothing can speak more 



DANGERS OF IMPERFECT HAND FEEDING 85 

strongly and decidedly than do the above figures, and there 
can be no greater proof of the necessity which exists for 
improvement in the care of our infants. We have become 
so accustomed to their frequent deaths that we look upon 
them as an unavoidable result. 

185. As the state of Michigan and the cities in this 
state are among the healthiest in the country, or any place 
in the world, this infantile mortality rate will apply to every 
state in our union, and, possibly, many of them will show 
a much higher rate of mortality than does the state of 
Michigan or the city of Detroit. 

DANGERS OF IMPERFECT HAND FEEDING 

186. The greatest care and judgment must be exercised 
by the mother or nurse in adjusting the proper quality and 
quantity of substitute foods to the digestive power of 
each set of digestive glands, in order to avoid damage to 
any of them (169). 

187. The rule is that all parts of the human body are 
strengthened by careful and judicious use, but are damaged 
by over-use or abuse. This means that if, in the digestive 
process, the artificial diet used contains no more fat or 
cream than the fat-digesting glands can consume perfectly, 
those glands will increase in strength and gradually con- 
sume a greater amount of this food. This rule also applies 
to the proteid and sugar-digesting glands (271). 

188. Where this rule is not observed, it is an impossi- 
bility to avoid injuring the infant's digestive power. While 
many infants will stand this abuse for a long time and yet 
manage to survive it (210), there is a large class of infants, 
born with weaker digestive powers and inheriting nervous 
or other susceptible constitutions (472), who have great 



86 FEEDING RULES FOR INFANTS 

difficulty in digesting enough artificial food during the first 
few months of their lives to enable them to make the usual 
increases in weight, growth and development. All these 
infants, other than the strong, robust ones, require the 
utmost care, judgment and attention, daily, to give them 
that continued suitable dietary which always results in 
healthy, -vigorous children (165). Hand-feeding, when 
properly done, can nearly always be depended upon to give 
results second to those produced by perfect human milk. 

FOODS AND THEIR SOURCES 

189. All foods are divided into two classes — the hydro- 
carbons, or heat-making foods, and the nitrogenous, or 
tissue-making foods. 

190. The hydrocarbons are utilized in the body to main- 
tain the temperature and to store up fuel in the form of fat, 
which can be utilized any time for heating purposes. This 
class comprises all fats, sugars and starches. 

191. The nitrogenous foods are the tissue makers of the 
body, and from these, all repair growth and development 
are mainly obtained. They appear in the various forms of 
proteids or albuminous foods. 

192. The above foods, with the additon of mineral salts, 
when well diluted in water, comprise all the elements which 
enter into the dietary of the human being. 

193. They are obtained from the following sources: 
Fats are found in milk, meat, fish, nuts, some fruits and 

all cereals. Oats and corn carry from eight to ten per cent. 
(307), and all other cereals about one per cent, or less. 

194. Sugars are found in milk and in many vegetable 
products, such as sugar-cane, sweet fruits, beets and some 
other vegetables. 



HUMAN MILK ASSISTS HAND-FEEDING 87 

195. Starches, being converted into sugar in the process 
of digestion, are classified under the same head as sugars. 
They form the bulk of all cereals, a large part of many 
fruits, about twenty-five per cent, of the bulk of the potato 
(313), and a small part of some vegetables. 

196. Proteids and albumens, which form the nitrogenous 
foods, are found in milk and eggs and form the lean part 
of meat and fish (624-417). 

197. The vegetable proteid is found almost entirely in 
the gluten which is the outer coating of all cereals covering 
the starch (315-318). The other forms of vegetable proteids 
cannot be utilized as human foods and do not require our 
consideration. 

HUMAN MILK AS AN ASSISTANT TO HAND-FEEDING 

198. It is amazing how much benefit is received by hand- 
fed infants from a few ounces of human milk daily. The 
good results seem to be far out of proportion to the amount 
given. This is very strongly illustrated in infants who fail 
with hand feeding. Physicians are astonished at what diffi- 
culties they frequently encounter in making a child grow- 
after cutting out the last one or two meals daily of even a 
poor human milk. It seems impossible that this small 
amount should be so very nutritious and do so much good, 
even when of an unsuitable character. Rather would it 
seem that this addition of human milk to the whole amount 
of food gives greater digestive power and enables the child 
to take more benefit from the cow's milk than it was 
possible to do without the mixture of human milk; in other 
words, it would seem as if the human milk carries a digestive 
ferment in itself which assists the infant in digesting foreign 
food. This is always a very important subject to remember 



88 FEEDING RULES FOR INFANTS 

when a feeble hand-fed infant has difficulty in digesting 
enough food to enable it to grow successfully. 

199. Aside from this digestive element, what is more 
noticeable is the very rapid growth and improved appearance, 
both in flesh and color, which a few ounces of human milk 
daily will give. There is no possibility in these cases of 
making a combination of foods without it, equal to a mixture 
which carries a small amount thereof. Where hand-fed 
children are suffering from loose, disturbed bowels and are 
cross, fretful and unable to make weight, the borrowing of 
six to eight ounces of human milk daily from another 
mother will, and does, go far towards saving a child's life 
and making it a happy, thrifty infant. 

200. It matters not what may be the age of the milk 
which is substituted in feeding another infant so long as the 
mother giving the milk has a happy child, is careful about 
her food, takes regular exercise and avoids taking medicine 
herself. Any time after her infant is a month old, the milk 
will be suitable for another child. Thus it will be seen that 
milk from a mother with a baby from one to ten months 
old may be used for an infant of any age so long as her own 
child is happy, comfortable and growing satisfactorily. It 
should be added to the other food, before feeding, in such 
quantities as will consume the regular amount of six to 
eight ounces daily. It is important that this regularity 
should be observed in the amount of human milk used from 
day to day, as irregularity in this article is sure to disturb 
the digestive organs of the infant. 

201. The desirability of using five to eight ounces of 
human milk in feeding feeble, delicate children during the 
first year, cannot be too strongly impressed upon our 
mothers. In any neighborhood where there are children, 



PREPARATION OF THE INFANT'S FOOD 89 

no difficulty should be encountered in finding a mother who 
will assist her sister in this way. Such is the motherly 
instinct. It is always her desire to assist another mother 
in this distressing position, and it should be more and more 
impressed upon women to cultivate this spirit of generosity 
and kindness, and also to teach mothers to ask for this as- 
sistance when the lives of their little ones are in danger. 

PREPARATION OF THE INFANT'S FOOD 

202. The proper preparation of the infant's food is so 
important that it demands special and careful consideration. 
This is a duty which should be performed by only one person, 
and by that person at the most suitable hour for good food 
each day, and not the hour most suitable to that person. 

203. Two persons can never prepare, measure or mix 
1 he different articles in the food in the same way. Variations 
in doing this work will nearly always give unsuitable results 
in an infant (173). 

204. The milk used in the preparation demands that the 
food be prepared at that hour when it is in the best possible 
condition to make a perfect food. It is unsafe to allow 
milk to stand longer than is necessary, as this waiting often 
means souring thereof, and milk always deteriorates with 
age even when kept upon ice. 

205. Articles requisite in preparing food: 

1st — An eight ounce graduate to measure the different 
articles. 

2d — One ounce dipper for removing cream from the bottle. 

3d — One tablespoon or one-half ounce measure for the 
sugar. 

4th — One quart pitcher to hold the mixed food. 

5th — One glass or enamel ware funnel to fill the bottles. 



90 FEEDING RULES FOR INFANTS 

6th — One bottle of lime-water. 

7th — One package of non-absorbent cotton to stopper the 
feeding bottles. 

8th — One dozen six or eight ounce round bottles to hold 
separate meals for each day. 

9th — One large dish, or tray, for holding the above articles. 

A graduate measure is necessary to measure water or 
milk properly. A tablespoon and a feeding bottle may be 
used for this purpose, allowing one half ounce for each 
tablespoon. The feeding bottle having been measured with 
the tablespoon can be used as a proximate measure, but it is 
always better to have a graduate glass for this purpose as 
the tablespoon may carry more or less than one half ounce, 
according to the way it is filled. A tablespoon may be 
heaped up one eighth more with water or only be seven- 
eighths full and both look the same to the ordinary observer. 
The graduate measure may be used only to prove the other 
measures, spoons, cups, etc., which cannot break with heat 
and may frhus be used under all conditions. The cream may 
be removed from the bottle by pulling it out with a spoon 
when pouring it off, instead of using a dipper. 

206. The first feature in preparing food is to make the 
sugar-water necessary for that day. A spoon can be used 
to measure sugar, but it is better to use a one-ounce glass 
ointment pot or glass measure, such as can be obtained at 
any drug store. In this the sugar can be packed and 
measured full or half, as needed, but the careful mother may 
use a tablespoon, packing and stroking the sugar to measure 
a half ounce. 

207. Milk-sugar is dissolved in the quantity of boiling 
water necessary and thoroughly stirred (407). This solution 
should be allowed to cool, and proper amounts of milk and 



FOOD EFFECTS AND THEIR SUBSTITUTES 91 

cream added for the whole day's feeding. When more 
than one ounce of cream is used to ever) r five ounces of milk, 
the milk should be used fresh (ill). As six ounces of fresh 
milk usually contain about one ounce of cream, all extra 
cream needed can be added to the fresh milk. 

208. When the food is all mixed, it should be divided into 
as many bottles as there are meals each day, and one, two or 
three teaspoonfuls of lime-water if needed, added to each 
bottle, acording to the size of the meals and the season of 
the year. Large meals and warm weather may require 
increases in the amount of lime-water (398). 

209. When the bottles are filled, they should be 
stoppered with cotton plugs and put upon ice. The cotton 
is needed to shut out new air and strain out bacteria in it. 
These cotton plugs should not be used twice and do not re- 
quire to fit the bottles tightly. 

The bottles should never be opened from the time the food. 
is prepared until it is fed to the infant, as each exposure to 
the air allows the souring bacteria to enter the milk again 
(281-283). These directions are all that are needed during 
the first two or three months. Starches are usually needed 
after three months (303). 

FOOD EFFECTS AND THEIR SUBSTITUTES 

210. The reserved power which nature has given in the 
digestive glands, as well as in all secreting organs in the 
healthy infant, enables it to care for extraordinary amounts 
of food and thus resist errors made, but only for a moderate 
time. Where errors are very large, the infant may resist 
them successfully for a week or ten days, and small errors 
may be resisted even for weeks, but it makes no difference 
whether they be large or small, the result is always the same 



92 FEEDING RULES FOR INFANTS 

(166), the only difference being that the attacks come more 
quickly with large errors than with small ones. 

211. Excessive amounts of fat, proteid or sugar injure 
those respective digestive glands required in converting 
them into healthy aliment. When an infant's digestive 
power is damaged in this way, an effort should be made to 
secure a proportion of foods which contains less of this in- 
jurious one and can be used as a substitute for the former 
dietary which caused the damage. It is a well known fact 
that there is no sugar, fat or proteid so suitable for an in- 
fant as these varieties found in milk, but other sources 
supply these foods and may occasionally be used as sub- 
stitutes for them (218). 

212. Where fat or cream has been over-fed and damage 
results therefrom, only small amounts will be digested for 
many months, but cod liver oil and other meat fats can 
generally be used. Many other fats have been tried, and, 
occasionally, one has been found satisfactory (300). 

213. Where an excess of milk proteids has been the 
cause of injuries, meat juices generally form the most 
suitable substitutions. In older infants soft-boiled egg may 
be used very successfully for this purpose (417). These 
are the only available proteids coming from the animal 
kingdom, which can assist or take the place of milk proteids. 
In young infants, especially in very young ones, they are 
not at all equal in value to the milk proteids and only a 
limited number of infants can digest them successfully. The 
tendency of overfeeding these animal proteids is to cause 
indigestion and loose, green mucous foul stools. Where 
they act in this way, the amount should immediately be re- 
duced w T ithin the possibility of perfect digestion, as shown 
by well-formed stools. Because milk proteids are not per- 



FOOD EFFECTS AND THEIR SUBSTITUTES 93 

fcctly digested and curds appear with formed loose, splashy 
stools, it is not necessary to remove them entirely, but the 
amount given should be reduced within the limits of perfect 
digestion. No matter how small the amount of fat or 
proteids may be which can be perfectly "digested, it is a very 
serious mistake to cut that small amount out of the infant's 
dietary (250). 

214. Milk-sugar, in substitute foods, when given in 
excessive amounts, causes irritation of the glands suited for 
its digestion, and, consequently, lessens the power to digest 
that food, the same as occurs with fat and proteids. This 
is shown by sour, splashy stools and reddened rectum. This 
condition requires feeding of smaller quantities of milk- 
sugar (409). 

215. When this reduction in milk-sugar impedes nu- 
trition, cane-sugar may be partially substituted for it (408). 
In many cases it becomes necessary to use a baked or boiled 
starch as a partial substitute or addition to the dietary, 
when scalding of the rectum and watery stools show that 
sugar of any kind cannot be digested. In these cases 
showing impaired sugar-digestive power, a malted starch can 
seldom be fed as a substitute or addition to the dietary (327). 

216. During the first three months, starch can be di- 
gested very feebly and extraordinary care is needed to pre- 
vent overfeeding it. Mothers make this mistake continually 
in feeding proprietary foods, which are mostly starch. 
Frequently they do this also with home-made starches (247). 

217. There are no substitutes for starches, so that an 
injury produced by this food must always be corrected by 
lessening the amount fed, trying another starch or varying 
the mode of preparation from a boiled to a baked or malted, 
or in any direction other than the original one (325). 



94 FEEDING RULES FOR INFANTS 

218. It is commonly found that the. injury to one kind of 
digestive glands is so great that they cannot be used with any 
form of substitution at that time. In these cases the dietan 7 
must be made up entirely with the other foods. This is 
very much to be regretted, as no infant can grow and 
develop so well who is not able to take some of all the foods 
— fat, proteids, sugar or starch. The hope for the future, 
in these cases, lies in nature's power to repair the damaged 
parts and also to grow new -glands as the infant becomes 
older. Unfortunately, in many infants, the injurious re- 
sults are so severe and decided that repair is impossible and 
these children grow up deficient in stature, strength and 
digestive power and always require extraordinary care and 
discretion in order to enjoy moderate health. These weak- 
nesses may continue for many months, or even years. With 
some, they continue all through life. 

THE HUNGRY CHILD 

219. One of the greatest difficulties which a mother has 
to encounter in feeding her infant is the continual reminder 
by everybody, when a child cries or makes any noise, that 
the infant must be hungry. So often does she hear this, 
that, in time, it becomes a source of irritation, and after 
having listened to this advice eight or ten times daily for a 
month or two, she comes to realize that this is the stock 
speech of her friends and means nothing whatever. While, 
in the beginning, she generally heeds this advice and occas- 
ionally tests it by giving the child more or different food, she 
soon discovers that she must use her own judgment regardless 
of what her friends, old or young, may say or think (186). 

220. When she arrives at this decision, she soon learns 
the infant's necessities and peculiarities of digestion by try- 



THE HUNGRY CHILD 05 

ing different sized meals (429). A mother who has, con- 
sistently from the child's birth, followed the directions of 
the feeding chart (370), in time, has very little doubt re- 
garding how to feed or manage her infant at any time. She 
soon learns that regular advances of the different foods in 
the dietary give such additions in weight or changes in 
temper, sleep and digestion that it is an impossibility for the 
child to suffer regularly from any disturbance other than 
hunger a few minutes before every time of feeding (345). 
When an infant's complaints are not of this character, she 
promptly recognizes the difference. This is one of the 
benefits that comes to mothers who know how much advance 
can be made in the food according to the changes in weight 
from day to day. The mother who has learned all the facts 
shown clearly by regularly filling the feeding chart each day, 
soon realizes the evidences of success which the infant 
presents at different hours of the day and feels independent 
of the foolish and senseless advices of kind, but thoughtless 
friends, and consequently, is not in danger of damaging her 
infant. 

221. The mother who has not been properly educated on 
this subject, and whose efforts to feed her own infant have 
resulted in damage thereto, is continually open to these dan- 
gerous suggestions of her friends (169). She has an infant 
whose complaints and cries may, and generally are, thought 
to arise from hunger, when, in reality, they are due to over- 
feeding or wrong food. 

222. The infant whose digestive organs have been con- 
tinually stimulated to immense effort by irregularity of 
meals either in the size, frequency or quality of the food, is 
sure to make complaints or show disturbances such as will 
lead the mother astray and make her think that it is hungry, 



96 FEEDING RULES FOR INFANTS 

when its stomach requires rest or different food. This 
happens mostly with infants who have been fed on a starchy 
diet, such as rice, barley, oatmeal or any of the proprietary 
foods. They are always craving for something, and are like 
the dyspeptic adult who feels relief for ten or fifteen minutes 
after meals and is in distress from that time until the next 
meal. The craving of the infant, in these cases, is for 
something that will allay this uncomfortable feeling in the 
stomach. A little water and lime-water will always do this 
better than food. A few drops of any hot drink, such as 
catnip, anise-seed, gin or whiskey and sugar-water will give 
the desired temporary relief. 

223. It is always better to test the condition of the 
stomach by giving these hot drinks, in small quantities, 
rather than food. When an infant is more comfortable after 
the drink than after the food, it shows clearly that it has 
been overfed (228). The untrained mother of the damaged 
infant does not know this, and, consequently, is more 
inclined to give food. She does not realize that what the 
child requires is rest for its stomach by receiving more 
suitable, or less, food (246). The meals can be made 
smaller, given regularly and never given until the infant is 
hungry. When this is done, the infant ceases to make this 
distressing mournful, dyspeptic cry, and, in time, is able to 
digest the smaller amount of food perfectly and grow more 
rapidly than it had done on the larger meals which it had 
not digested. 

FREQUENCY OF MEALS 

224. This is a subject of the greatest importance and 
one that always requires most careful thought. As there 
are all ages of infants, there must be all sizes of stomachs 



FREQUENCY OF MEALS 97 

from one ounce (in the new-born) upwards. This variation 
in size allows larger meals as the infant grows older, and 
also longer intervals between meals (287). 

225. As in the adult, meals are always lessened with sick- 
ness and consequent decrease in digestive power, so must 
this also be done with the infant whose digestion has been dis- 
turbed by any cause (428). Infants who have been improp- 
erly fed in amounts, as well as in quality, of food have some 
digestive glands injured or destroyed. Just in proportion 
to the number thus crippled or unable to secrete enough 
digestive fluid is the power to digest food at any one meal 
reduced, and just in like ratio with this reduced secretion 
must the frequency of the meals be increased in order to 
nourish the infant properly and give healthy formed stools 
(G51). 

226. Hundreds of the writer's infantile feeding charts, 
rilled by the mothers and showing the amounts and kinds of 
foods fed daily, demonstrate clearly that in infants there can 
be no increase in weight when they are kept hungry more 
than five to ten minutes between meals (501). 

227. These feeding charts also show that intervals of 
hunger, twenty to thirty minutes long, between meals, will 
always cause a loss of four to six ounces weekly in weight; 
and when these intervals of hunger average ten to fifteen 
minutes regularly, the weight will usually be stationery. The 
above rules regarding hunger and weight apply only to in- 
fants who are properly fed, and, consequently, have only one, 
or at most two, healthy, well-formed stools each day (654). 

228. When infants are improperly fed, either in the 
quality of food or in the amounts thereof, the stools will be 
foul, frequent, soft or splashy (263). In such infants, there 
can be no gain in weight, but, on the contrary, there must be 



98 FEEDING RULES FOR INFANTS 

loss. In these cases, there is a continual craving for drink 
or food and the crossness o-f the infant must not be mis- 
taken for hunger and more food given (222). The propor- 
tion of food must always be changed or reduced, where 
stools are of the above unhealthy characters, until they come 
formed and are not more than one or two daily. When this 
proof of correct feeding and perfect digestion has been 
secured, the infant may be classed with those having healthy 
digestive glands, and the hungry intervals between meals 
must not be more than five to ten minutes long in order to 
have the infant grow and thrive satisfactorily (654). 

229. As infants having unhealthy stools are always suffer- 
ing from indigestion, either in the stomach or bowels, small 
meals must be given; and in many badly injured infants, 
these small sized meals must be continued for weeks or 
months to secure that success only shown by healthy formed 
stools (428). 

230. From the above different conditions in infants, it is 
apparent that the frequency of meals must always be gov- 
erned by the digestive power of the infant. . Some infants, 
badly damaged by improper feeding, may require small meals 
every houi, while others of the same age, who are better 
developed or whose digestive organs have never been injured, 
may be able to take meals large enough to satisfy hunger for 
three or four hours. The great necessity in all cases is to 
give that size meal which makes the infant happy, and repeat 
it often enough to keep its digestion occupied almost con- 
tinuously while awake. This is the only condition which 
always guarantees the successful growth and development of 
any infant (696). The greatest' care must be observed in 
regulating the whole amount fed daily. Irregularity in this 
feature always means failure. If the infant is happy and 



INCREASES OF FOODS 99 

gives healthy, well-digested stools on thirty ounces daily, it 
will be cross in daytime and sleep poorly at night on two 
to four ounces less and will also be cross, gassy, sleepless and 
give foul stools on one to four ounces more than thirty daily. 

INCREASES OF FOODS 

231. As skim-milk gives strength and growth to the in- 
fant (389), it is always the most important part of the 
infant's dietary and also the one which requires to be most 
carefully handled. Well-fed, healthy growing infants of 
twelve to fifteen pounds in weight cannot properly digest ad- 
ditions of skim-milk greater than two and one-half to three 
teaspoonfuls each week. This, it will be observed, is less than 
one-half teaspoonful a day. Infants weighing only seven to 
nine pounds, and on full diet, cannot digest increases of one- 
half teaspoonful daily excepting for a week or ten days, as 
sickness always follows long-continued large increases (241). 

232. It is important that the mother remember, in all her 
additions to the food, that perfect digestion must always be 
the only condition allowing further additions of any kind 
whatsoever, either in the quality of the food or quantity 
thereof. This perfect digestion is proven, on a milk diet, by 
the yellow, partially formed stools free from foul odors and 
not more than one or two each day. All additions to the 
milk diet give darker, but formed, stools when properly 
digested. 

233. In order that the mother may estimate the probable 
amounts of these different foods which will be requisite, expe- 
rience shows that, in cold weather, infants nine or ten months 
of age, weighing usually from eighteen to nineteen pounds, do 
not require, in their daily food, more than three to four, 
ounces of cream and from twenty to twenty-five ounces of 



100 - FEEDING RULES FOR INFANTS 

skim-milk, all diluted with fifteen to twenty ounces boiled 
water, the whole mixture carrying from fifteen to twenty tea- 
spoons of some well-cooked starch and sweetened with three to 
four teaspoonfuls of granulated sugar (243). In summer- 
time they cannot digest this amount of milk. 

234. Every pound of weight in an infant requires so 
much food each day to nourish it properly and prevent loss 
thereof. All increases in weight require extra food to retain 
these increases. From this, it is evident that the amount of 
food needed in every infant must be governed by the size 
and weight of the child, rather than by its age (255). 

235. Having considered these facts required by the 
mother to guide her in her increases of food, we will consider 
the different additions needed as the child advances in age. 

236. The original milk-sugar solution of six to seven per 
cent. (408) may be strengthened whenever the infant can 
take a larger proportion of this food. When there is an 
abundance of milk-sugar in' the dietary, it is better to make 
further additions to the six or seven per cent, sugar solution 
by occasionally adding one teaspoonful of granulated sugar, 
to the 'whole day's food, as long as this addition does not 
produce a gassy or colicky condition or does not cause any 
redness around the rectum or watery stools (409). 

237. The rule which the mother must now follow, in the 
correctly growing infant, is never to make more than one 
change in the foods or the whole amount of the daily dietary 
and then wait one or two days for the comfort of the infant 
and a healthy formed stool, to prove the correctness of the 
last advance (246). 

238. By following this rule, she can make only a very 
small error and can always correct it by going back to the 
point where everything was properly digested. In this way. 



INCREASES OF FOODS 101 

she will never increase two foods at the same time, nor 
increase any food, and, at the same time, increase the size 
of the meals. Where a food is increased in the day's dietary 
the size of the meals should always remain the same. Where 
the size of one or two meals is increased in any day, it is not 
safe to increase the strength of the food. To keep the work 
simple and clear, it is better that all additions should be 
continued in one food only until the restlessness of the child 
or unhealthy stools prove that it has reached the highest 
point of perfect digestion of that food. As soon as this oc- 
curs with any food, advances should be made every second 
third or fourth day in another food until the point of perfect 
digestion in that is also reached. Having advanced all the 
foods, the next change should be made in the size of the 
meals. An increase over the amount suitable to the infant 
in every increase in the diet is indicated by the increased 
amount of gas thrown out of the bowels or belched from the, 
stomach (491), and also by the foul odors of the gas and 
stools, as well as the tendency to increase the number and 
softness of the stools. At this point, the infant becomes 
cross, restless and sleeps poorly (289). - . 

, 239. If we look at the amount of food wjiich will be 
consumed by the new born infant and at. the a'mount which 
• will be consumed by the same infant when it is nine or ten 
' months old, we will realize that the advances made from 
> day to day must indeed be very small in order to be correct. 
It is only by thinking over carefully what these differences 
are that we quickly appreciate, how small the daily advances 
must be to avoid doing harm. 

240. The new-born infant may consume two to four tea- 
spoonfuls of cream daily. The infant of two months may con- 
sume twenty-five teaspoonfuls daily, thus leaving about eigh- 



102 FEEDING RULES FOR INFANTS 

teen to twenty teaspoonfuls of cream to be added to the 
infant's dietary during the first eight weeks, or an average of 
two and one-half teaspoonfuls each week during these first 
two months, and it may not be able to digest more than this 
amount any month afterwards. 

241. The increases of skim-milk will be comparatively 
the same, but continue longer. The total amounts of skim- 
milk consumed from three to ten months will be very much 
larger than of cream. Probably, the infant of one month 
will consume one-half ounce daily and the large healthy 
infant of ten months about twenty-five ounces daily. These 
twenty-four ounces of milk represent one hundred forty-four 
teaspoonfuls, which, divided among forty-two weeks, will 
show a necessary increase of only about three and one-third 
teaspoonfuls weekly, or, in other words, about one-half tea- 
spoonful each day (231). 

These estimates of increase are amounts which healthy, 
well-nourished children will be able to digest. Smaller 
infants will not be able to appropriate these amounts. 

242. Realizing now what is needed for success, the mother 
must remember that the foundation of her food is her sugar 
solution and that it is already of full strength (407), not 
requiring additions excepting the increases of the whole 
mixture as the child demands more food. 

243. Having fed skim-milk, which contains all proteids 
necessary for the child's repair, growth and development 
(389), and having also added a proportion of cream which 
carries the fat needed for heating the infant, for lubricating 
the bowels and softening the stools (379), she must now be 
guided by the stools and weight for further additions to the 
dietary. When the stools become constipated and the bowels 
have difficulty in moving, the indications will be to add a 



INCREASES OF FOODS 103 

teaspoonful of cream every two days until the stools resume 
the requisite-softness but still retain some form. It will be 
observed that, as the stools become softer, they show more 
yellow in color. When stools show the requisite softness 
and more food is demanded, additions must be made of skim- 
milk. Usually, after the second month, the amount of skim- 
milk needed is from two to ten times more than the cream, 
and the amount of sugar is about one-twentieth of the whole 
day's food and the water mixture until starch is added. 

244. To feed well and avoid all possibility of damaging the 
infant with unsuitable dietary, it is absolutely necessary for 
the infant to be weighed regularly, as there is a limit to the 
speed at which the hand-fed infant can grow. During the 
first six months, this rate of increase can seldom be more 
than one ounce daily; from six to nine months, never more 
than one-half to three-quarters of an ounce a day, and from 
nine to twelve months, not more than one-half ounce each 
day (475). While these figures should not be looked upon 
as an unchangeable guide, yet they express conditions which 
are necessary to observe in feeding a healthy, vigorous child 
so that it may continue to be healthy and free from all di- 
gestive or physical blemishes, and at the end of the first fif- 
teen months, if properly fed, will be able to take largely of a 
solid dietary (735). 

245. It is quite a common thing for an overfed infant to 
thrive and improve with advances in food, and, when these 
additions are stopped, to continue growing and making 
weight just as rapidly for three, or even four weeks as it 
did before the increases ceased. This occurs only with 
infants who are fed too liberally. All increases of food 
should be stopped occasionally for a few days to ascertain 
whether they are needed or not. 



104 FEEDING RULES FOR INFANTS 

246. When it is found that after the increases in food 
are checked, the infant fails to make weight and becomes 
restless and wakeful, particularly at night, without any 
gassy disturbances or foul odors, it is plain that more food 
is required (267). When the mother fails to prove net- 
work by giving her infant this rest, she is likely to advance 
the dietary too far and cause acute indigestion, diarrhea 
or dysentery (223). 

GENERAL PRINCIPLES GOVERNING NECESSARY 
CHANGES IN FOOD 

247. The infant commences life with digestive glands 
suited for the conversion of animal foods only. As the child 
grows, new glands are continually being added to those in 
existence and the existing ones are increasing in size, strength 
and number, so that, as the child becomes older and is 
properly fed, its power to digest larger amounts of food is 
greatly increased. When two or three months old, the 
healthy infant is enabled to digest different forms of starch, 
if properly prepared and given in suitable small amounts, 
in addition to the sugar, fat and proteids which it has been 
receiving in its milk dietary from birth (303). In infants 
two to three months old, there is a moderate power of starch 
digestion and this when needed, assists materially in modify- 
ing the diet. When the sugar, fat, proteids and starch are 
carefully raised up to the infant's capacity and increased 
steadily as the child digests h perfectly, there is no dis- 
turbance produced in the digestive tract, no sickness results 
through the dietary and the infant grows steadily from 
month to month (696). 

248. In an infant fed in this way, the only change re- 
quisite is to gradually increase each food as the infant be- 



PRINCIPLES GOVERNING .CHANGES IN FOOD 105 

comes older, and when about a year old, possibly, also lessen 
the amount of fat or proteid which has been fed originally. 
There is, perhaps, only one exception to this and that is 
the necessity for reducing the milk-sugar steadily while 
increasing the starch dietary (-412). 

2-49. Where an infant shows imperfect progress and 
failure to make weight, the error can always be found, if a 
digestive one, in the amount or character of the fat, proteid 
or sugar which has been fed. Usually this can be traced by 
the stools to the particular food which is wrong and that one 
can be reduced to the necessary amount (263). 

250. Because a food has been found to disagree, it 
should not be entirely discarded from the dietary until it is 
clearly shown that the digestion is disturbed by the smallest 
amount of it. In order to save time in making changes it 
may be best to remove that food entirely from the dietary. 
Should this removal be followed by correct stools and a 
happier condition of the child, an effort should be made to 
put it back in small quantities until the exact amount which 
the child can digest perfectly and comfortably is shown. It 
is a great mistake to permanently remove any one food 
from the dietary of the infant until the soft, foul, mucous 
or watery character of the stools shows clearly that none 
of it can be digested. An effort should always be made to 
retain the largest amount of every food which can be di- 
gested with comfort and which shows no disturbance in the 
stools (186). 

251. In many infants, nursed or hand-fed, whose past 
progress shows irregular growth and frequent intestinal 
disturbances while fed upon a purely milk diet, the power to 
digest one or more of the foods in milk has been very much 
lessened or, perhaps, entirely lost. This is an unfortunate 



106 FEEDING RULES FOR INFANTS 

condition and will demand most careful thought and study 
to select dietary which will take the place of these milk 
foods, or such parts of them as it may be necessary to 
remove from the infant's meals (253). Very commonly, 
it is found that the infant who does fairly well without any 
cream is sickened immediately on the addition of one tea- 
spoonful thereof to the whole day's food (300). Again, it is 
very common for infants to fail in digesting skim-milk until 
this is reduced to a small quantity, perhaps six or eight 
ounces daily. It is not so common to find the power to 
digest sugar decreased or lost (410). 

252. In infants over eight months old, the difficulties in 
substituting other foods for those in milk are very much 
lessened. The starch digesting power of these infants is so 
much increased as well as the power to digest different 
proteids, that they are more easily fed when they are 
damaged than they would have been when much younger. 
There are great varieties of starches, both liquid and solid, 
which are suitable for infants of this age (329). It is then 
that crackers, toast, crusts (771), and gluten foods (317) can 
be fed in small amounts. 

253. The general principle, then, in these cases, is to re- 
duce foods which the infant has been consuming in excess to 
that point where healthy formed stools are produced (266), 
and to substitute other forms of the same food or some of 
the different varieties of starch (324) and gradually build up 
a diet which the infant can digest perfectly and upon which 
it can grow. All these changes must be done gradually 
and cautiously, being careful not to injure any more di- 
gestive glands or bring on attacks of vomiting, diarrhea or 
dysentery by making too rapid changes in the amount or 
quality of the food (237). 



WHEN AND HOW TO CHANGE THE FOOD 107 

254. To assist in doing this work systematically and 
carefully, the author, has been compelled, from experience, 
to devise a feeding chart which shows, in the daily dietary, 
the amount of each food, the size and number of meals in 
daytime and at night, the character of the digestion as 
proven by the stools, the changes in the weight of the infant, 
the character of the sleep and temper and the length of time 
which an infant requires to digest each meal. 

By examining each question on this chart, we will have 
the summary of all information usually requisite in feeding 
infants (370). 

WHEN AND HOW TO CHANGE THE BABY'S FOOD 

255. 1st — When an infant with healthy formed stools does 
not gain in weight, increase the size of some meals or feed 
more frequently. If there is still no gain, increase the size 
of more meals or of every meal, and if this does not bring 
the desired result, increase one of the foods contained 
therein. These increases, to be successful, must give 
healthy stools. A sick stomach, gassy discharges, foul 
odors and loose bowels following any increase are evidences 
of an error in the food or overfeeding (238). An infant 
cannot gain in weight who is hungry more than five to ten 
minutes between meals (226). 

256. 2d — The hungry baby cries, sucks its fingers, sleeps 
poorly, awakens frequently, but does not suffer from belch- 
ing of gas, foul odors from the stools or extra gassy dis- 
charges (219-223). The food must, in this case, follow the 
same directions as in No. 1. 

257. 3d — Vomiting immediately after a meal is evidence 
either that the meal is too large, the baby has been raised 
up too soon, has been shaken up too much, has too much 



108 FEEDING RULES FOR INFANTS ' 

pressure on the stomach or the food is wrong in some way 
(451). 

258. 4th — When vomiting or spitting of water occurs 
between meals, the meal is too dilute and too large and the 
water in the food requires to be reduced until this ceases 
(449). 

259. 5th — Vomiting of food thirty or forty minutes after 
eating or before the next meal indicates that there is too 
much cream or sugar in the food (382 and 452). 

260. 6th — Baby has colic. This is known by belching of 
gas and intermittent sharp cries with relief after passing gas 
from the bowel. The meal itself, or some part of it, is too 
strong and causes indigestion. Reduce the proteids (skim- 
milk). If this does not give relief, reduce the cream, sugar 
or starch. Colic is usually accompanied by soft green or 
mucous stools when the proteids are too high. A properly 
fed infant does not suffer from colic (152). 

261. 7th — Fever. When baby is feverish from any cause, 
the ' meals should always be reduced in size — one quarter to 
one half — in proportion to the fever. If the fever is very 
high, (103 to 104 degrees), the food should be stopped 
entirely for one, two or three days (506-508). An abundance 
of water should always be given to replace the food which 
has been removed and also to satisfy the thirst (337). 

262. 8th — Loss of appetite. This occurs mostly in 
infants who look and act well. They are usually over- 
fed. 

Reduce the strength of the food one eighth or one quarter, 
making up the amount reduced with warm water. Excess 
of cream usually causes loss of appetite. It should be 
reduced and skim-milk increased the same amount, in 
infants who are not growing satisfactorily (300). 



WHEN AND HOW TO CHANGE THE FOOD 109 

263. 9th — Baby has unhealthy stools: 

When stools arc very yellow, foul, greasy or ropy, reduce 
the cream. 

When curds appear in the stools, reduce the skim-milk. 

When stools arc very dry, crumbly and of a grayish-yellow 
color, increase the cream (2-13) and reduce the skim-milk. 

When stools are green with much mucus in them, re- 
duce the whole food one quarter or even more, or reduce 
the skim-milk only. 

When splashy or gassy foul stools follow a healthy condi- 
tion on previous days, take out the last addition or reduce 
the whole amount of food. 

Where starch is a part of the diet and it is necessary to 
increase it in order to increase the weight of the child, if such 
addition causes soft, gassy stools, reduce the sugar (412). 

Additions of meat juices and starches always produce a 
darker or brownish color in the stools (463). 

264. All changes in food are made to improve the con- 
dition of the infant. 

265. When the digestion is perfect and the infant is 
unhappy, all changes should be increases of food to satisfy 
that hunger which causes this crying, fretting and un- 
happiness (256). 

266. When foul, many colored, gassy stools show that 
digestion is imperfect, the dietary can never be increased. 
That food in the diet which is not perfectly digested and 
causes these unhealthy stools must be reduced until healthy 
stools appear. Often these stools show that all the food 
must be reduced to produce that healthy consistence and 
odor requisite for health (249), and perfect development. 

267. The foods in use can never be increased while stools 
are foul odored, slimy, waterv, e^ssv, foamy, many colored 



110 FEEDING RULES FOR INFANTS 

or numerous, but they can be increased when the child is 
constipated or the stools well formed. All increases should 
be made as per paragraphs 231-246. 

FEEDING THE DAMAGED INFANT 

268. It is a common thing to see a nursed or hand-fed in- 
fant damaged in its digestive power so that it does not 
weigh more than one half to three quarters of the average 
weight. This very small size may be seen at any age from 
two weeks upward. These infants are usually long enough, 
but they fail in the amount of flesh they should carry in 
proportion to their length. This result is, of course, ob- 
tained by the unsuitability of quality and amounts of foods 
which have been given them, and our efforts must be made to 
correct past errors by assisting these infants who have only 
a limited power of digestion to appropriate "the food or 
foods necessary for their success (103). These cases may 
have been nursed or hand-fed previously, and usually show 
the greatest difficulties encountered in hand-feeding. The 
unusual anxiety and desire of the parents to make the hand- 
fed infant grow is a common cause of this condition (171). 

269. Where errors occur in the dietary, due to the 
wrong quality of any one of the elementary foods or to any 
of those foods being : r ed in excess of the digestive power, 
the infant is usually irritated at the point which has been 
over-worked. This occurs with imperfect nursing and also 
with unsuitable hand-feeding, and where it continues for any 
length of time, the pale color of the infant, its soft flesh and 
failure to increase in weight indicate a condition that de- 
mands a change in the dietary (249). 

270. The younger the infant is in whom this mistake 
occurs, the greater is the difficulty in correcting the error; 



FEEDING THE DAMAGED INFANT 111 

and in very young children, those under two or three months 
of age, it requires the greatest care to correct these errors 
without using good human milk as a substitute for the 
present diet (198). 

271. There is one principle which must always be ob- 
served; that is, to keep the infant's digestion healthy even if 
it remains light in weight, and this is done by feeding only 
that amount of each food which is perfectly digested and 
gives well formed stools. Where this principle does not con- 
tinually govern every move, change and addition to the food, 
good results cannot follow the most anxious efforts for the 
child's improvement (187). 

272. These infants should be weighed regularly every 
day on a reliable pair of scales, and as long as they do not 
lose weight, the present dietary is a safe one and all ad- 
ditions and changes in the food must be those which give 
one or two healthy, well-formed stools each day (244). The 
rule applying to this condition, is that stated above (271), 
knowing well that, in time, new glands will grow with the 
child's growth and the old ones will be strengthened and im- 
proved, so that, in the course of a few weeks or months, the 
child's digestion will, if properly cared for in the meantime, 
be able to appropriate larger amounts of food. 

273. This is always a very trying time to both parents 
and physicians who are all usually worried much by the 
kind but untimely suggestions of friends, neighbors and even 
strangers. There is only one way out of this complication 
and that is by the rule above cited; so long as the infant 
digests enough food to hold its own weight or perhaps gain 
an ounce each week, its future success is assured. 

274. Where the scales show that the infant is gradually 
losing weight, it is apparent that the damage has been very 



112 FEEDING RULES FOR INFANTS 

great, indeed, and prompt efforts must be made by making 
small changes in or additions to the food to check that los:, 
of weight (255), but usually some weight must be lost, before 
a suitable amount of the correct food is secured to check it. 

275. In all these trying cases, the very beneficial effects 
of peptonizing the proteid foods must be remembered (150- 
156). When this is not sufficient, the great power and 
nourishing qualities of good human milk should always be 
remembered (198). 

FEEDING IN HOT WEATHER 

276. The digestive power of an infant changes with the 
different seasons of the year, the same as that of an adult. 
With the approach of cooler weather in the fall, all physicians 
notice a marked improvement in the digestive powers of 
infants under their charge. Mothers who have raised several 
children have also noticed this fact, and look forward to the 
approach of cool weather as a means of correcting slight 
disturbances from which their children suffer during the 
warm season. It is a noticeable and well-marked fact that 
many infants' lives have been saved merely by the advent 
of cooler weather (280). 

277. Statistics show that infants commence to make 
weight rapidly in the fall, when cool weather approaches, and 
continue to do so during all the cool weather, as long as 
they are properly fed(l80). Experience also shows that 
these same children fail to show those' increases in weight 
during the hot summer months and that many of them really 
lose weight without showing much evidence of sickness. No 
efforts should be made to obtain those rapid increases in 
weight, during the hot summer weather, which are possible 
during the cooler weather. 



FEEDING IN HOT WEATHER 113 

278. The beneficial effects of the cool season are so well 
known and so generally recognized that it is a standing cus- 
tom, in all large cities, for people to provide for a change of 
residence during the heated term. Such parents usually 
send their children to the mountains, to the seashore or 
farther north where the weather is much cooler than in hot 
cities. In doing this they recognize that the child's digestive 
power is always better in cooler locations than in hot ones. 
This applies to infants who are teething as well as those who 
have passed -beyond that stage (341). 

279. Where it is impossible for parents to avail them- 
selves of this change of climate, it becomes necessary for 
them to realize what they must do to secure safety and 
remain at home during the hot season. If they would con- 
sider the difference in their own habits, their own desires 
and the changes they make to insure their own comfort in 
hot weather, they would have a more or less reliable guide 
in caring for their young infants and children. 

Every healthy individual notices that his appetite decreases 
and his thirst increases in hot weather. Sensible people 
usually follow this indication and, instead of eating such 
large quantities of meat, potatoes, bread and other strong, 
rich dietary, they partake more of the lighter articles, very 
materially increasing the amount of drink which they consume. 
In this way they do not suffer from indigestion or diarrhea 
and are able to regularly perform their ordinary duties. It is 
only necessary that infants should be given the same privileges 
that parents demand for themselves; that means, in hot weather, 
to lessen and lighten the food they consume and increase the 
amount of water which they are allowed to drink (142). 

280. • When as much strong food is continued in summer, 
digestive disturbances are likely to follow and sickness, with 



114 FEEDING RULES FOR INFANTS 

great loss in weight, will be the consequence. The digestive 
power of an infant is reduced just in' proportion as the heat 
increases. The natural and necessary inference, therefore, 
is that the food should always be decreased in one or more 
meals on hot days. It should always be a standing rule with 
mothers, in hot weather, never to feed any oftener than the 
regular meals, but to satisfy the crying and uneasiness of 
the infant by giving it frequent drinks of water. If this is 
done regularly, the infant will not demand such large meals 
and will very frequently refuse a portion of them. In this 
way they unconsciously protect themselves from sickness, 
remain happy and sleep well. Infants, treated in this way, 
do not .suffer from summer diarrhea (337). One liberal 
drink of milk in hot weather kills many a child. 

CARE OF THE FOOD IN THE SUMMER TIME 

281. Fermentation or decomposition of food increases 
in rapidity in direct proportion to the increase of heat dur- 
ing the summer season. This fact demands the utmost care 
on the part of the mother to protect the food from those 
changes which will be injurious to the infant. This applies 
to all forms of food, but more particularly to milk and meat 
juices. An abundance of ice must be used to maintain a 
continued low temperature in the refrigerator or ice-box 
where the food is kept. Changes in the temperature of 
the food through temporary shortage of ice are very danger- 
ous indeed. It must be the aim and object of the mother 
to so completely preserve the coldness of the food that there 
can be no possibility of hot air affecting it unfavorably (209). 
The most violent cholera infantum and all other forms of 
summer diarrheas are caused by sour milk food (366) or 
decomposing meat juices. To avoid this, the mother should 



AMOUNT OF FOOD AND SIZE OF BABY 115 

prepare the food as soon as possible (204). All milk must 
be pasteurized (145) or sterilized (148), cooled quickly with 
the stream of cold water and then placed upon ice. A slow 
process of cooling food without the use of cold water or ice 
is sufficient to destroy all the beneficial results produced by 
pasteurization. 

282. Care should always be taken, especially in the sum- 
mer time, to see that the infant takes its meals while they 
are yet warm. Where a child is allowed to doze and stop 
nursing, the foo'd should be immediately removed. In the 
warm but not too hot condition, animal foods spoil very 
rapidly; consequently, it is a necessity to make the infant take 
its food at once and never leave the bottle to be taken after it 
has cooled off. Giving cold food to an infant who is accus- 
tomed to hot food is very liable to cause indigestion and colic. 

283. The practice of propping the bottle upon a pillow 
with the nipple in the baby's mouth, thus allowing the 
infant to doze while taking its food, can not be too strongly 
condemned. This is especially the case during the hot sum- 
mer season, and the life of many an infant has been sacrificed 
through this careless, thoughtless habit. The bottle should 
always be held while the infant is nursing, and as soon as 
it ceases to draw, from any cause whatever, it should be 
removed at once, the contents thrown away and the bottle 
rinsed (365). It is never safe to heat a meal over again and 
use it as a second feeding. 

AMOUNT OF FOOD AND SIZE OF BABY 

284. The two main factors which cause failure in feed- 
ing young infants are: 

1st. — Using wrong foods. 

2d. — Giving too large meals (171), 



116 FEEDING RULES FOR INFANTS 

285. As we have treated the foods suitable for infantile 
feeding in different articles, we will now consider the amount 
of food suitable for infants of different ages. 

286. It is a well recognized fact that the capacity of the 
stomach is in proportion to the weight of the infant; con- 
sequently, an infant of four or five pounds in weight, when 
born, is unable to take as much food as an infant of eight or 
nine pounds. 

287. The average weight of the new-born infant is from 
seven to seven and one-half pounds and the capacity of its 
stomach will average about one ounce, or six teaspoonfuls. 
As the infant grows very rapidly during the first three 
months, the stomach must increase in size in the same pro- 
portionate speed. The infant one month old, when properly 
fed, has grown so rapidly that the stomach will hold about 
two ounces, or twice as much as when it was born. 

288. At the end of three months, this infant, if healthy, 
has grown so rapidly that its stomach capacity is four 
times greater than it was at birth, or four ounces. As the 
growth of the infant after three months is much less rapid 
for the next three months, the increase of the stomach 
capacity is correspondingly less and increases with decreas- 
ing rapidity in proportion to the child's age and growth from 
this time onward. 

289. It will thus be seen that, as the increases in weight 
and in the size of the stomach are in direct proportion to 
each other during each quarter of the first year, the meals 
must increase only in corresponding ratio. Very seldom 
will it be found necessary to give an infant, under a year 
old, meals larger than six to seven ounces. While many 
infants, fed very dilute foods, are often given eight, ten or 
even twelve ounces at a meal, this can never be done with 



FOODS REQUIRED IN THE INFANT'S i^EAL 117 

safety when foods are of the proper strength. Meals of 
such large size stretch the stomach and weaken the digestive 
power correspondingly (434). The addition of so much 
water to the food throws an immense strain upon the kid- 
neys and keeps the child constantly urinating. This can be 
of no advantage, but, on the other hand, lays the foundation 
for future Bright's disease in many cases (338). 

FOODS REQUIRED IN THE INFANT'S MEAL 

290. As we have previously shown, there are three foods 
in human milk, and, in the infant, a corresponding supply 
of glands to secrete the fluid suitable for digesting these 
three foods (33). 

291. If we could obtain an unlimited supply of human 
milk, we could follow nature's proportions of these foods 

without any trouble and expect to have good results at all 
times in feeding healthy, normal infants; but, as the amount 
of human milk obtainable is very limited, we are compelled 
to procure the fat, proteids and sugar from the next 
best source, which is cow's milk; but they are not the 
same as those in human milk. This fact at once presents 
many difficulties of which the inexperienced have little con- 
ception. 

292. The general principle of feeding with cow's milk 
was based by many physicians upon the proportions of foods 
in human milk, but this division is well known to be a very 
uncertain and unreliable guide. Selecting the amount of 
fat, proteid and sugar necessary for feeding an infant from 
cow's milk, according to the human proportion, very quickly 
convinces any one that the figures must be wrong or that 
the foods in the two milks are not of the same quality. In 
direct proportion to experience in doing this work will be 



118 ^FEEDING RULES FOR INFANTS 

the conviction that these foods in human and cow's milk are 
very unlike each other in quality and in their effects upon 
the human infant. If this were not the case, we would not 
have the great difficulties which are frequently encountered 
in adjusting a diet, made of these foods, to the digestive 
capacity of infants (94-97). 

293. To meet these difficulties as they are encountered 
in different parts of the country from the milk of various 
cows fed upon different foods, it is necessary to be governed 
not by one formula, but to have the privilege of using one 
out of many formulas, always selecting that one which 
agrees best with the infant and which makes a happy child 
— one who always has healthy, natural stools. The follow- 
ing schedules of formulas (573-579) have been found by the 
author necessary to meet the many variations in milk in 
different localities and also the varying digestive secretions 
of infants at all ages. These formulas are given at differ- 
ent ages and for different weights of infants, thus enabling 
the mother to commence substituting food at any time dur- 
ing the first year of the infant's life. 

294. Any formula, to be successful, must give the fol- 
lowing results in healthy infants: 

1st — Weight increasing steadily. 

2d — A happy baby while awake. 

3d — An abundance of quiet and continued sleep. 

4th — One or two natural soft or formed stools daily. 

5th — Freedom from foul odors or frequent gassy dis- 
charges from mouth or rectum. 

Only that formula which gives the above results will guar- 
antee present and future success in an infant's growth and 
development. 



TOP-MILK 119 

297. Top-milk is recommended by some writers for 
infantile feeding. A twelve-per-cent. top-milk is made by 
mixing equal parts of ordinary cream and fresh milk to- 
gether. If very "heavy" thick cream is used, there should 
be three parts fresh milk to one part of this very "heavy" 
thick cream. 

298. The best way to obtain twelve-per-cent. milk is to 
place the fresh milk in a tall glass jar, such as a fruit jar 
or a milk bottle, and let it stand surrounded by ice or in a 
cold room (forty degrees) for four or five hours. The upper 
one-fifth (six ounces from one quart) may be calculated to 
contain twelve per cent. fat. If the milk is very rich, the 
upper one-fourth (eight ounces from one quart) may be used. 
If milk is used which has been bottled at a dairy the day 
before, the upper one-fourth (eight ounces from one quart) 
may be calculated to contain twelve per cent. fat. This 
top-milk may either be removed by skimming or the bottom 
layer of milk may be siphoned off, leaving the number of 
ounces of top-milk desired. Should more than six ounces 
of the twelve-per-cent. milk be needed, two quarts of milk 
should be set. The proportion of fat in these mixtures is 
very uncertain. 

299. If milk can be obtained fresh from the cows, it is 
to be preferred on account of its purity (562). The food 
can then be made up when the milk is but a few hours old 
(559 to 561). 

300. Experience shows, in feeding top-milk, that very 
many children are not able to digest much fat, and a con- 
tinuance of this high percentage of* top-milk in the dietary 
entirely destroys the power of the digestive glands to dispose 
of this item. Many infants who have been fed in this way 



120 FEEDING RULES FOR INFANTS 

for a time become unable to take care of the fat, as it 
causes vomiting, and frequently has to be very much reduced 
or removed entirely, as the smallest portion can not be 
digested. In these cases, skim-milk has to be substituted 
for both milk and cream. 

301. To suit the digestion of all infants, the following 
schedules (573-579) will show the amounts of this food and 
other foods needed in feeding them. The great variation in 
the proportion of the different foods in these schedules will 
impress the reader with the imperative necessity that exists 
to always adjust the amount of each food to the actual di- 
gestive power of the infant rather than by fixed ideas of 
what each infant can or ought to take (187). Without 
knowing the effect of each food upon the digestive power, 
it is impossible for any one to feed an infant correctly and 
guarantee its future growth and development (272). 

STARCH 

302. Starch, in its many forms, composes sixty per 
cent, of the dietary of the adult, and animal foods make up 
the other forty per cent. The young infant, in its growth 
and development, necessarily passes from the entirely animal 
dietary of the first iew months to one composed more or 
less similar to that of the adult. Nature has so arranged 
it, that while she does not give the infant the ability to 
digest starch, except in very moderate quantities during the 
early months of its life, yet the secretion of saliva in the 
fourth month and the consequent drooling of the infant indi- 
cates the increasing power of the little one to take this in 
addition to those foods which milk supplies (581). 



WHEN AND HOW TO FEED STARCH 121 

WHEN TO COMMENCE FEEDING STARCH AND HOW 
TO FEED IT 

303. Very little starch can be fed during the first three 
months, but, in some infants who must be hand-fed, small 
portions can be advantageously used during this time. As 
the infant's digestive power increases and changes some- 
what between three and six months, it allows starch to be 
increased materially during this period. Between six and 
nine months, any healthy infant can and should consume a 
fair proportion of some starch in addition to its regular 
milk diet. After nine months, this amount of starch should 
be very materially increased, and, in most cases, the milk 
diet will decrease somewhat during this time (252). Before 
the infant is fifteen months old, it is always able and should 
consume a diet, which is, at least, one-half starch and largely 
of the dry kind which the parents use themselves (735-740). 

304. During the first three months, starch may be pre- 
pared for food by boiling, thus making what is termed 
starch-water, always of a fixed strength. This boiling is 
called dextrinizing the starch when it is thoroughly done. 
Usually, this strength is one tablespoonful of oatmeal, 
wheat, rice or barley flour or two tablespoonfuls of the flakes 
to a pint of the finished product. This starch-water must 
be added cautiously, not more than one teaspoonful to 
ever}- second or third bottle as a commencement of this diet- 
ary. If it does not show any fermentation in the way of 
gassy discharges from the bowels or stomach, this amount 
can be repeated and gradually increased as long as it does 
not make the infant colicky, gass} 7 , uncomfortable or cause 
it to be too constipated. Increases in starch should not be 
made of tener than every second day, as this time will always 
show whether they are digested comfortably. Where starch 



122 FEEDING RULES FOR INFANTS 

makes the child gassy, colicky and uncomfortable, smaller 
amounts should be used and another, such as a baked 
starch, tried (217). When a satisfactory starch has been 
secured, the amount can be gradually increased as the child 
grows older, so long as it is comfortably digested (330). 

305. Starch, in the form of flour or flakes, requires from 
one-half to one hour of rapid boiling to dissolve it suitably 
for feeding. Nearly all starches are now prepared in the 
form of flakes, most of them being used as breakfast foods. 
As these foods are already baked and ready for adult diges- 
tion, they only require half an hour of steady boiling to 
make them suitable for infantile food (329). 

STARCH IN ITS RELATION TO SUGAR 

306. All starch is converted into sugar in the process of 
digestion; consequently, it always supplants or reduces the 
amount of sugar in the dietary in proportion as it is added 
thereto. The indications for this reduction are increased 
amounts of gassy discharges, or redness and scalding about 
the rectum. If these do not receive early attention, the child 
soon becomes cross, colicky and very gassy, with watery, 
splashy stools. 

FEEDING STARCHES AND EFFECTS THEREFROM 

307. A pure starch is a constipating food and additions 
of it to the milk dietary have this effect (,316). All starches 
carry a certain amount of fat and are relaxing in direct 
proportion to the amount of this food which they carry. 
Oats and corn have the largest amount of this article, about 
eight per cent. They are, consequently, the most relaxing 
starches. Of these two, the oat starch is preferable, as it 
1 as an agreeable taste and makes a smooth, pleasant mix- 



SALT IN GRUEL AND MILK FOODS 123 

ture with milk. Corn-meal is very seldom used in this way. 
Rice, barley and wheat have less than one per cent, of fat 
and are therefore mote constipating than oatmeal. Of 
these three, rice starch is the most easily digested, carries 
the least fat and is most constipating. It makes a very thin 
starch-water, passes through the nipple easily and is a 
favorite with mothers. This allows the strength to be 
greatly increased when needed for older infants (304). 

308. Barley is not so constipating as the rice nor so re- 
laxing as the oatmeal. The varying effects of these different 
starches always allow a selection of the one most suitable 
to the digestive power of each infant. When an infant 
shows inability to digest the fat in milk, it will nearly always 
be found impossible to feed oat starch, as the fat in this 
food effects the child much the same as that in milk. 

309. As oatmeal is relaxing to the bowels and rice is con- 
stipating, these two foods are commonly mixed together in 
a proportion necessary to give healthy, well-formed stools. 
By alternating these two articles or mixing them together, 
the varying conditions of constipation and looseness in the 
stools can generally be corrected. 

310. In addition to the above starches, arrowroot, tap- 
ioca, corn-starch and farina are valuable starch foods and 
can be cooked in the same way. 

311. The comparative strength of all starches can be 
estimated by their weight. Usually, one tablespoonful of 
the meal flour, or broken grain, is equal to two tablespoon- 
fuls of the flakes. 

SALT IN GRUEL AND MILK FOODS 

312. In the preparation of the different foods for young 
infants, the question frequently arises regarding the addition 



124 FEEDING RULES FOR INFANTS 

of salt. This is an important one. The addition of a very 
small proportion of salt is nearly always desirable, but not 
to such an extent as to be tasted in the food. Salt fre- 
quently has a laxative effect and may cause a weak, loose 
condition of the bowels when added too freely. As all 
starches, excepting that from oatmeal, are constipating 
when fed in proper quantities, that is, below the point of 
fermentation in the bowels, salt may cause confusion if it 
relaxes, and thus demand unnecessary changes of the starch, 
or such reduction as will avoid these loose stools (307). It 
is therefore better, in very young infants, that very little 
salt be added to the foods. There is generally enough of 
this article in the mother's milk or in cow's milk for perfect 
digestion and nutrition. In older infants, who are taking 
more starch food and less milk, salt can be added in 
moderate quantities with advantage to digestion and benefit 
to the child. 

POTATO AS AN INFANTILE FOOD 

313. Potatoes carry from twenty to twenty-five per cent, 
of starch, the balance being made up mostly of water and 
cellulose, which is a wood fiber containing no nutriment of 
value. It is a very favorite form of food with young 
children, and when of a good dry variety, is very suitable as 
a diet for infants over a year old. During the summer- 
time, when old potatoes are soft and soggy and the new ones 
are not thoroughly matured, this form of starch should not 
be given to young children. When fed at this season of the 
year, it is very difficult to digest and, very commonly, causes 
stomach disturbances. 

314. Potato starch cannot be used as an addition to the 
milk dietary of very yoir~£ infants and is greatly inferior in 



GLUTEN 125 

value to wheat, rice or barley starch for all infants under a 

year old. 

GLUTEN 

315. Gluten is a vegetable proteid, an element which 
gives strength and growth to our domestic animals. It is 
found as a thin layer of cells immediately under the horny 
layer of all grains or cereals and also forms a large part of 
all grasses. When it is desirable to add a vegetable proteid 
to the dietary, it is better to select a flaked food, as it carries 
the starch and gluten together, or take a pure gluten food. 

316. Starches form the great body of all grains or cereals 
(195). Pure starch is entirely white in appearance (307). 

Where the whole grain is ground, the gluten and starch 
mixed together give the product a dark shade. In our 
commercial manufacture of flour, machinery has been so 
perfected as to remove the outer part, or glutinous coat, of 
the grain and leave the pure white flour alone. This flour 
is almost pure starch. It will be seen, then, that where it 
is necessary to add vegetable proteid to the dietary, it is not 
desirable to select the very white starch, but rather take one 
that is dark in color. To avoid confusion and uncertainty 
on this point, gluten food or gluten flour may be selected 
as part of the flour dietary. Manufacturers of proprietary 
foods necessarily darken the starches in their process of 
malting or baking the foods, and this color should not lead 
us astray in selecting them instead of a food carrying a fair 
or natural proportion of gluten. 

317. Great care must be exercised in the addition of 
gluten to the infant's dietary, as only small portions of it 
can be digested, and excessive amounts thereof will cause 
fermentation and loose stools. Additions should not be 
larger than half a teaspoonful to the whole day's dietary 



126 FEEDING RULES FOR INFANTS 

until the well-formed stools of the infant prove that it can 
digest a larger quantity, and then additions of this amount 
should not be made more frequently than every second or 
third day. 

318. Gluten foods are mostly obtained as a by-product 
in the manufacture of corn-starch and are sold in packages 
like other breakfast foods in all large cities. Gluten flour, 
which is dark in appearance is also sold for making bread 
and bi.scuits. Gluten water is made as per 784. 

PROPRIETARY FOODS 

319. Under this head can be included all dry forms of 
proprietary or patent foods, and also the greater part of 
those foods in the moist or liquid forms. Manufacturers of 
these foods depend mostly upon wheat for the bulk of them. 
Some use barley, and an occasional one oats, but where they 
do not mention barley or oats on the label, wheat flour is 
the only form which they use. 

320. In making these proprietary foods, the wheat flour is 
either malted or baked and put upon the market either 
alone or in combination with dried milk, egg or some other 
commodity, ^us making a simple or a complex mixture. 
The malted starches are represented by "Mellin's Food" and 
"Horlick's Food" (327). The baked starch is represented 
by "Imperial Granum." All of these are good foods when 
given in proper quantities to infants whose digestive organs 
are suited for them. Some infants can digest malted starch 
and become constipated, while with others, it acts as a 
laxative and therefore cannot be continued except in those 
small amounts which give only one or two well-formed 
stools each day. "Imperial Granum" is a very good food 
and does not cause such relaxing effects as the malted starch, 



PROPRIETARY FOODS 127 

often requiring the addition of malted starch to overcome 
constipation. The mixed proprietary foods suit some in- 
fants and, like other forms of food, are injurious to others. 
Some of them, such as "Malted Milk," are mixtures of 
malted starch and dried milk. Others are mixtures of 
baked starch with milk, such as "Nestle's Food." Others, 
such as "Eskay," mix their baked starch with sugar, dried 
egg, and some with other ingredients also. 

321. "Robinson's Barley Flour" is a very good form of 
starch and is easily digested by those infants to whom it is 
suited. "Robinson's Groats" is a preparation of oat starch. 
Both of these articles are readily and easily prepared, re- 
quiring only a few minutes' cooking. 

322. In these foods composed of baked starch, the wheat 
flour is made into thin cakes, perforated freely and baked 
thoroughly. These cakes are then ground into a fine 
powder similar to flour. This process of baking ruptures 
the starch cells and renders it more digestible for infants in 
the same way as well-baked bread is more comfortable to 
the tender stomach of the adult than is raw, under-done 
bread. This ground powder makes "Imperial Granum" and 
the great bulk of mostly all the other proprietary foods by 
the additions of dried milk, egg and a little malt. 

323. In other preparations, some of the foods are made 
by adding dried milk to the hiked starchflour, making a very 
good food. Of this type, 'Nestle's Food" is a good illus- 
tration. In all Kquid foods placed upon the market, there is 
a large proportion of starch, but, as they are more complex 
mixtures, there is always more uncertainty in feeding them 
to natural .children. These liquid foods may be used for a 
short time for some infants who are unable to digest or- 
dinary milk or milk and starch dietary, but as it is always 



128 FEEDING RULES FOR INFANTS 

more difficult to estimate the value of complicated foods, they 
should never be used when the starch and milk mixtures give 
satisfactory results. 

SELECTING STARCH FOR THE INFANT 

324. In selecting starch for infantile feeding, only those 
forms should be used which make the child comfortable and 
give fairly formed stools. Unsuitable starches will make 
the child colicky and give unformed stools, even when fed 
in very small quantities. The error often lies in selecting 
a malted starch when a baked one should be used, or in 
selecting a boiled starch when a malted one is necessary, or 
in selecting a baked starch when a malted one is more suit- 
able. That form of starch is correct which always makes 
a comfortable baby and gives a formed stool. As the pre- 
paration of starch is intended to rupture the little envelopes 
in which all starch granules are enclosed and partially digest 
it, this process may not be complete enough to suit the 
infant's digestive glands. It is therefore evident that the 
preparation of starch is a very important factor in deter- 
mining its suitability for each and every infant (G39). 

325. Very often the form of starch given to an infant is 
made unsuitable and injurious by not respecting the capacity 
of the child's stomach in the amount fed at each meal. 
Every preparation of starch is unsuitable to an infant if 
fed in amounts beyond the capacity of that special digestive 
fluid secreted for its comersion into healthy aliment. All 
foods which enter the digestive tract are either digested or 
decomposed. That amount of suitable food which is not 
beyond the infant's capacity at any meal is always digested 
comfortably and makes the child happy. All excesses of 
foods, starches or otherwise, which are given beyond the 



SELECTING STARCH FOR THE INFANT 120 

capacity of the digestive fluid, secreted at that time, must 
decompose and make the child unhappy and distressed. 
Excessive amounts of starch produce watery, splashy, scald- 
ing, pasty, white or clay-colored stools. 

326. Raw or partially cooked starches are always very 
difficult to digest. They ferment easily and produce sour, 
gassy, watery stools; but, if fed in a milk mixture, the stools 
may be foul and sour, due to the decomposition produced 
in milk when starch ferments. It will thus be seen that, 
in boiled and baked starches, these errors must be due to 
overfeeding or the fatty character of the starch when the 
cooking is properly done. This error is found most commonly 
in food made from oats and occasionally from barley (217). 

327. Starch which is produced by the malting process is 
relaxing to a great many infants, and can be fed only in 
those amounts which give healthy formed stools. This 
relaxing power is a valuable quality, and small additions 
of malt or malted starch to the dietary generally overcome 
the obstinate constipation often produced by boiled and bake 
starches. The process of malting converts starch into a 
grape-sugar, and this makes a very sweet food suitable for 
many young infants with very delicate digestive organs 
(306). Manufacturers claim that no sugar is needed when 
malted starch is added to the milk diet, but as many infents 
can take this food in addition to the malted starch, the two 
foods may be combined when they give healthy formed stools. 
In the home preparation of the infant's food, starches are 
obtained from different sources, and they should be selected 
in that form which is most easily and perfectly cooked (307). 

328. The following table shows different forms of starch 
suitable for the mother's use, the length of time required for 
cooking and the amount of water needed in the preparation: 



130 



FEEDING RULES FOR INFANTS 



329. 



STARCHES 



Quaker Oats 

Rice 

Durkee's Rice.... 

Rice 

Wheat 

Arrowroot 

Tapioca 

Barley 

Robinson's 

Robinson's Groats 



Flakes 

Grain 

Flour 

Flakes 

Flakes 



Grain 
Flour 
Flour 



AMOUNT 
TABLE- 
SPOONS 



WATER ENOUGH 




WHEN* FINISHED 


BOIL 


TO MAKE 


HOURS 


1 pint 


/2 


1 pint 


2 


1 pint 


54 


1 pint 


54 


1 pint 


54 


1 pint 


54 


1 pint 


54 


1 pint 


2 


1 pint 


54 


1 pint 


y 2 



IN DOUBLE 
BOILER. 
HOURS 



330. All the above starches, when mixed with milk, arc 
valuable foods to feed to infants. The above proportions 
are strong enough to use for the first four weeks, or until 
formed stools show perfect digestion. The strength can then 
be gradually increased if digestion be perfect as proven by 
formed stools. 

331. As wheat flakes are the only kind of starch in 
nearly all breakfast flakes, such as "Wheatina," "Petti- 
john's," "Ralston," "Boston Brown," etc., any breakfast 
flake can be used which has not been sweetened or mixed 
with other ingredients. 

332. Combinations of the above starches can be used, 
when necessary, to change the taste or to correct the con- 
dition of the bowels. Any or all of them will loosen the 
bowels when fed too freely. "Quaker Oats" is the most 
relaxing one. As the flakes are baked and the flour is fine, 
these forms should always be used, when possible, as they 
can be boiled most perfectly and in a shorter time than the 
whole grains or meals. 

SOUR STOMACH 

333. Mothers are very frequently alarmed by the sour 
character of food vomited. Many look upon this as an error 



GIVING WATER TO THE BABY 131 

requiring treatment. Food, when vomited, may be either 
sweet or sour, according to the length of time since it was 
swallowed. If vomited immediately after being taken there 
is little change in it. If vomited later on, between the 
meals, it must always be sour to be correct. Digestive fluid 
is necessarily sour when in full activity. As there is no 
digestive fluid lying in the stomach when food is taken, the 
food vomited then has not had time to be changed from its 
original character. Digestive fluid is secreted by the glands 
in the walls of the stomach immediately after food is taken, 
and as the amount of this fluid increases steadily until the 
meal is digested, the contents of the stomach must neces- 
sarily be sour until the work is ended. 

334. From the above, it will be seen that the sour 
character is the correct one, excepting immediately after the 
food is swallowed. 

335. There is a condition of extreme sourness which 
appears in the deranged or irritated stomach and food re- 
turned is always intensely sour in these patients. These 
children have been wrongly or overfed and always require 
medical advice with lessened or altered diet. This extremely 
sour condition of the food is usually traceable to excess of 
sugar or some sweet food. In many cases it is traceable to 
the excess of Mellin's Food, Malted Milk or any form of 
sweet proprietary food. Usually, this extremely sour 
vomiting may occur at feeding time or later. 

GIVING WATER TO THE BABY 

336. There is a very strong sentiment in favor of giving 
an infant water to drink at all seasons of the year and at all 
ages. Mothers very commonly ask if it is necessary to do 
this or they follow this practice without consulting a physi- 



132 FEEDING RULES FOR INFANTS 

cian. During cold weather this subject is of no importance 
whatever, especially with very young infants, as little or no 
harm can be done by giving small drinks of water, for 
infants will not take any more than they desire. Mothers for- 
get the fact that all milk contains seven parts of water for 
every part it contains of food. This should be enough for 
any healthy infant. In hand-feeding, milk is still more 
diluted with water and this may overwork the kidneys in pro- 
portion as it is given above the natural needs of the body (289). 

337. It is very much better for the mother to err in 
giving an extra amount of water than to refuse that full 
amount that the child requires. An insufficient supply of 
liquid or water causes suffering, mainly during the hot 
season of the year, or when infants are in some feverish 
condition (261). There is scarcely any time or condition 
when an infant should be refused water, but, unfortunately, 
the cries and demands of a child, especially in hot weather, 
are not always properly recognized and the mother uncon- 
sciously refrains from giving it the drink for which the infant 
is calling. An infant who is properly fed and yet appears 
dissatisfied should always be tested with a drink of warm or 
cold water rather than with additional food. The substance 
of this subject, then, is for mothers to always satisfy the 
child with a drink of water whenever she is able to do so, 
and if this does not give satisfaction, she may then think of 
feeding it or use some other treatment which may be sug- 
gested to her (223). 

338. Some mothers prepare a bottle of water, sweetened 
or flavored in some way, and give this to the infant regularly 
between meals. This is usually an error when the infant 
is properly fed. For a well-fed infant, sugar may be bene- 
ficial as a food, but persistent overworking of the kidneys 



TEETHING 133 

with surplus water must be weakening and injurious to 
these organs (289). 

GIVING LAXATIVES TO INFANTS 

339. One of the popular practices with mothers is the 
giving of "castor oil" or "Castoria" to overcome constipa- 
tion or for the mere sake of being in the fashion of giving 
something to the infant, ostensibly to relieve colic and pre- 
vent green stools. While one laxative is beneficial in the 
beginning of a sickness where there is fever, the habit of 
repeating it should be condemned. Laxatives never cure 
constipation and are never of any benefit to a healthy baby. 

They will relieve colic and remove green stools for a few 
hours, but they will not remove the cause of the colic or 
green stools. Laxatives may be used to remove the poi- 
sonous products resulting from unsuitable food or overfeed- 
ing, but when the bowels are very loose, nature is busy re- 
moving the results of some dietetic error, and the mother's 
attention should be given to correcting the amount of food 
or quality thereof which causes the error rather than per- 
sistently giving physic to carry off the results of it. No 
medicine acts as a laxative upon the bowels except by the 
irritation which it causes to the whole digestive tract. In 
doing this, it is acting like the unsuitable food that is 
creating the damage and injury; consequently, the repetition 
of anything that acts in this way cannot be other than in- 
jurious to the infant. 

If an infant is fed correctly, it is always injured by the 
use of laxatives. 

TEETHING 

340. Dentition, or teething, in the healthy infant, when 
properly fed, commences about the seventh month and ends 



134 FEEDING RULES FOR INFANTS 

at two or two and one-half years. It is generally under- 
stood that infants are more susceptible to disturbances of 
the digestive organs during the teething period. There can 
be little doubt of this fact with many children; but there is 
a large proportion of them who, if properly fed, experience 
no disturbances of any kind from cutting their teeth. 

341. It is generally acknowledged by all that children 
have little difficulty in teething during cold weather and 
mothers are only apprehensive on this subject during the 
hot summer months. A little thought will convince any 
intelligent parent that nature has not designed teething to 
be more difficult in itself during the warm weather than dur- 
ing the cold. Of this there can be no doubt; but experience 
shows that infants do suffer a great deal more from digestive 
disturbances in summer than they do in winter. This being 
the case , and teething not being the cause of any extra 
difficulty in summer, it must be traceable to other errors. 
This is undoubtedly true and the errors are found in the 
dietary (269). 

342. It is a very important matter for every parent to 
realize the truth on this subject, because, in following the 
old inherited idea that all summer diarrheas are due to 
teething, they fail to give these disturbances that attention 
which they demand and which they should promptly receive. 
They are inclined to think lightly of them and wait until 
the teeth appear before making any effort to relieve the in- 
fant of its sickness. In this way they generally allow the 
sickness to become more severe and the infant to be more and 
more wasted and debilitated until, too often, it is too late to 
save the little one's life. When mothers realize that an im- 
perfectly fed infant must always have more bowel disturb- 
ances during the hot weather on account of its weaker di- 



CRIES OF INFANTS 135 

gestive power, they will be relieved of the great dangers 
which they believe to be always necessary during the 
heated term, for these mothers will then learn to promptly 
lessen the food and increase the water as the weather be- 
comes hotter and when the bowels show an unusual activity, 
have medical treatment at once. 

HICCUP OR HICCOUGH 

343. Hiccup, or hiccough, always appears in children 
who have been overfed. It is caused by a spasmodic con- 
traction of the diaphragm, and is due to the pressure of 
a very full stomach against the nerves, or due to fermentation 
of food in the stomach, swelling it up and giving it an undue 
size and consequent pressure. Hiccough should always be 
associated with an overfed condition, and when this appears, 
it should be a warning to reduce the next meal, and also 
not to feed quite so liberally. Unless there are persistent 
and frequently repeated attacks of hiccough, we seldom find 
any bad results following its presence. The infant who 
suffers from this disturbance resembles the adult who has 
taken a heavy Sunday dinner and consequently does not re- 
quire much supper that day. In this way he usually feels well 
and has a good appetite for his Monday morning breakfast. 

CRIES OF INFANTS 

344. Infants cry from various causes: 1st, hunger; 2d, 
thirst; 3d, pain; 4th, sleepiness; 5th, wants attention; 6th, 
wet napkins; 7th, fright; 8th, temper; 9th, uncomfortable 
position; 10th, uncomfortable clothing. 

345. 1st — Hunger. Hunger causes crying before the 
next meal hour and is accompanied by sucking of the hands 
and inability to sleep. This cry stops as soon as the infant 
is fed (256). 



136 FEEDING RULES FOR INFANTS 

346. 2d — Thirst. This causes a continuous cry and 
worry which is not stopped by food, but immediately ceases 
when given a drink of water. 

347. 3d — Pain. This causes sharp, loud, piercing cries 
accompanied by such motions as give relief, or increased by 
such motions as aggravate the pain. This may be due to 
colic (260), rheumatism, pricking pin, rupture or any form 
of irritation painful in its character. A very persistent 
crying or wailing, with no apparent reason for it, is generally 
due to an earache or swollen gums from approaching teeth. 

348. 4th — Sleepiness. This is a very vigorous sharp 
cry at first, soon accompanied by efforts to sleep, such as 
closing the eyelids. This cry gradually grows less distinct 
and lower in character until sleep is obtained. 

349. 5th — Wants attention. In some infants this is a 
most obstinate and persevering cry. It occurs in children 
after a long sickness where they have received undue care 
and attention, and it is a natural condition in infants with a 
too-indulgent parent. They stop immediately when they 
receive the attention they desire. This never appears in 
some families, but it always does in others. Every woman 
lias her own way of raising an infant. Many mothers fear 
to discipline a crying infant lest it become ruptured. There 
is little cause for this apprehension. Some mothers let the 
infant cr}^ it out and end the trouble. Other mothers have 
not the courage to do this and continue slaving for and 
spoiling the little tyrant. 

350. 6th — Wet Napkins. Every mother quickly recog- 
nizes this as a cause for crying and corrects it by putting 
on a dry one. 

351. 7th — Fright. An infant may awake from sleep with 
a loud cry or scream due to some dream or noise. All 



CRIES OF INFANTS 137 

frightened infants should be appeased by the mother's pres- 
ence, either taking it up or turning it over and giving it 
such attention as she always does to appease it. 

352. 8th — Temper. Infants frequently become tyrants 
and exhibit marked temper when not indulged in everything 
they desire. It is useless to advise mothers how to correct 
this. Some can and will do it, and, consequently, have 
nothing to complain about in the temper of their infants. 
Other mothers have not the heart or courage to control 
their infants and so develop an overbearing temper by their 
indulgence. These mothers usually try to overcome fits of 
temper in an infant by diverting its attention to toys, to 
other people, by carrying it around or by giving it all the 
bric-a-brac in the house to break. On this subject every 
mother is a law to herself and can not be taught by any 
outsider (499). 

353. 9th — Uncomfortable position. Crying from an 
uncomfortable position usually occurs during sleep in very 
young infants. The mother corrects this by turning the 
child into a new position and by replacing the clothes. This 
is generally sufficient. The position of the child when 
awake is changed so frequently that it seldom cries from this 
cause. 

354. 10th — Uncomfortable clothing. A mother very 
quickly learns to examine the clothing of an infant when it 
cries obstinately. Most generally, the clothing is uncom- 
fortable on account of being too heavy in hot weather or 
too light in cold weather. At times clothing is uncomfort- 
able by being too tight at points, and this is corrected by 
being loosened. Some nurses have the foolish habit of draw- 
ing a band very tight around an infant to avoid having the 
child ruptured. This is a very senseless habit. A band 



138 FEEDING RULES FOR INFANTS 

should never be so tight that the mother's ringers can not 
slip easily underneath it and also allow room for a large 
meal. An infant in a very tight band is always in an 
uncomfortable condition after being fed. 

355. Healthy crying is essential for the proper develop- 
ment of the lungs, muscles and chest. This form of crying 
is not of long duration and it is not necessary to encourage 
it from a health point of view. All infants do enough of 
this without being required to do so for health's sake alone. 
Usually, this occurs most frequently in the evening before 
being prepared for the night's rest. 

WASHING THE BABY'S MOUTH 

356. There is, at present, a strong wave of teaching in 
favor of washing a baby's mouth with "boric acid," "lister- 
ine" or some other antiseptic solution after each feeding. 
This, like many other new things in the medical world, has 
been taken up and advocated more strongly than the necess- 
ities of the situation demand. While it would be wrong to 
condemn this altogether, yet it is the opinion, of the writer 
that considerable harm is done to the delicate lining of the 
mouth by the intense enthusiasm of many nurses and mothers 
in their efforts to do something that does not require doing 
and thus, they claim, prevent it from attacks of sore mouth. 

357. If a careful mother gently rubs the child's mouth 
with any solution in a little absorbent cotton on the end of 
her finger, possibly no harm will result therefrom, but it 
certainly does not seem that nature intended any healthy 
infant's mouth to require washing every time it takes food. 
The lining of the mouth is always a wet surface and is being 
continually washed by the secretions flowing from the lining 
membrane as well as from the salivary glands. This really 



WASHING THE BABY'S MOUTH 139 

seems to be a natural wash designed by nature to do this 
work. The history of ages shows that this must always 
have been all the antiseptic necessary. Experience also 
shows that a healthy, well-nourished child seldom, if ever, 
has a sore mouth. This disease always comes in infants 
who are improperly fed and poorly nourished. In these 
infants, there is at times a tendency towards sore mouth 
from slight provocation, and possibly washing at that time 
with an antiseptic lotion, such as a teaspoonful of boric acid 
in a cup of warm water two or three times a day, will be 
beneficial. 

358. When an infant actually has contracted a sore 
mouth and shows great difficulty in taking its food, this 
method of washing it with the ringer and absorbent cotton, 
no matter how gently it is done, is a painful operation. It 
is infinitely better, when there is any evidence of soreness, 
to allow the infant to do the mouth-washing with its own 
tongue. In this way, the work will be done more perfectly, 
and with no pain or irritation to the child. A mixture of 
boric acid, one part, and powdered sugar, two parts, can 
be used for this purpose by placing a small pinch of this 
dry powder inside the lips immediately after each feeding. 
Any infant, with or without sore mouth, requires to secrete 
the necessary amount of fluid to dissolve it, and in so doing, 
this process of dissolving will cause the wash to be effectually 
applied to all parts of the mouth and the infant will experi- 
ence no pain or discomfort thereby. This plan of dressing 
an infant's mouth, whether sore or otherwise, is infinitely 
superior to any wash, which must necessarily be painful 
and irritating while being applied in any way. Where an 
infant is suffering from sore mouth and requires frequent 
dressings in order to kill germs which are causing the irri- 



140 FEEDING RULES FOR INFANTS 

tation, this dry powder should be put inside the lips every 
two hours during the daytime. As there is nothing poison- 
ous or dangerous in this application, the amount used should 
always be increased in proportion to the severity of the 
soreness. 

NIPPLES 

359. There are many patterns of nipples used for nursing 
infants. Those made of black rubber should be the purest, 
as all rubber is of that color when in its natural condition. 
Other colors are produced by some treatment, and possibly, 
in some cases, by the additions of lead to give sufficient 
stiffness. The black nipple is the preferable one and the 
shape and size thereof should conform as much as possible 
to that of the human nipple. Young and small children use 
the small-sized nipple, and, as they grow older, the size may 
be increased. The ordinary cone-shaped nipple, a little 
broader at the base where it fits on the bottle than at the 
point, is the most desirable one. Different forms have been 
adopted by manufacturers in order to overcome the difficulty 
of collapsing as well as to present other features which are 
more or less imaginary in the advantages which are claimed 
for them. 

360. The opening of the nipple should be of small size so 
that, when the bottle is inverted, the milk will only fall in 
drops from it. Where the hole in the nipple is large enough 
to allow streams of milk to fall out, the infant will receive its 
food too rapidly. It seems to be nature's design that the 
infant should, when taking its food, have the same exercise 
that the adult requires in mastication. Just as it is neces- 
sary for the adult to masticate his food properly, so is it 
likewise necessary that the infant should labor with its jaws 
in drawing the milk from the breast or bottle in order to 



NIPPLES 141 

stimulate that flow of saliva which we use in the mastication 
of our food. It is not well then, that the infant should be 
allowed to receive its food too rapidly, for many infants 
suffer from indigestion and colic through so doing. It 
would seem as if the salivary secretions are just as necessary 
for the proper digestion of an infant's food after it is three 
or four months old as they would be for the same child 
when it is being fed entirely on a solid dietary (302). 

3G1. Nipples should be removed from the bottle im- 
mediately after feeding and put to soak at once in salt or 
soda-water after being washed on the outside, inverted and 
washed on the inside also, so as to remove all drops of milk 
which may lodge there and cause souring of the next food on 
which that nipple is used. Nipples should always be put in salt 
or soda-water and rinsed carefully before being again used to 
feed the infant. Properly kept nipples will last for one or two 
weeks, and many mothers become so expert with them that 
they can use a nipple continuously for a month or six weeks. 
. 3G2. One great difficulty that mothers encounter i-s the 
collapsing of the nipple when it becomes soft after being 
used. This is overcome in the Mizpah pattern by a little 
valve which allows the air to enter the bottle as rapidly as 
the food is drawn out. This collapsing tendency can be 
overcome in any nipple by bending a small wire or string 
over the edge of the bottle mouth and drawing the nipple 
over this. In this way the air can enter along the side of 
the wire or string while the in-fant is feeding. It can also 
be overcome by dropping one end of a thin rubber band 
into the nipple and pulling the other end over the neck of 
the bottle with the nipple. Any wire, string or rubber 
which allows a little leakage of air to enter the nipple while 
nursing will effect this result. 



142 FEEDING RULES FOR INFANTS 

BOTTLES 

363. There are many forms of nursing bottles offered 
on the market. Possibly the most satisfactory one is the 
straight cylindrical bottle holding eight ounces, with figures 
and marks on the side dividing it into ounces and half 
ounces. This bottle has a mouth large enough to carry a 
full-sized nipple and also be easily cleansed. There are no 
angles or difficult places to reach in cleansing it, and conse- 
quently, it can be kept free from dirt or sour milk. 

364. Many flat, boat-shaped bottles with straight or 
crooked necks are also used and marked into half ounces, 
but as they are more difficult to clean, they present no ad- 
vantages over the cylinder-shaped bottle and are therefore 
less desirable. A mother should carefully ascertain whether 
the markings indicating the measurement on the side of the 
bottle are correct, as they vary to some extent, and fre- 
quently an infant, when fed by incorrect markings, may be 
underfed or overfed and thus damaged. 

365- All bottles should be rinsed immediately after being 
used and then filled with salt or soda-water to await the 
general washing next morning. They can be washed with 
brush, shot, gravel or wood ashes and hot water. This can 
be done more perfectly with a cylinder bottle than with any 
other shaped one. 

366. The necessity of adopting some system by which 
bottles can be thoroughly cleansed at all times is so important 
that no mother who understands this subject can, in justice 
to her own child, omit doing this work thoroughly on every 
occasion. It is with some difficulty and most absolute 
cleanliness during the hot weather that bottles can be kept 
so clean and free from sour milk and other infections 
that the child will be .protected from the ordinary diarrhea 



BOTTLES 143 

and other diseases of the summer season. One dirty bottle 
or nipple or one wrongly prepared meal in hot weather is 
often sufficient to bring on an attack of vomiting, cholera 
infantum, dysentary or convulsions (281). 

367. The old-fashioned bottle with a long rubber tube 
attachment connected with the nipple is so dangerous and so 
frequently does it breed sickness that it should never be used 
at any time of the year or any conditions whatever. It is 
impossible to clean it perfectly, and enough dirt and souring 
material will always lodge in the tube to endanger the life 
of the child who uses it. All bottles should be boiled every 
morning for at least ten minutes and set on a clean shelf to 
drain in the inverted position. This can be done in an 
ordinary dish, if necessary. 

368. When a mother desires a more perfect methDd, 
possibly Dr. Kilmer's nursing bottle boiler is as convenient 
and perfect an article for this purpose as we have. It is 
also a sterilizer and pasteurizer, convenient and inexpensive. 



CHAPTER VII 
THE FEEDING CHART 

370. The object of this chart is to educate young 
mothers to know what is wrong in feeding their chitdren. 
No mother will allow an error to continue when she knows 
that it is an error and that it will lead to sickness and 
endanger the child's life or future health. It is always the 
continuation of an error which leads to severe sickness and 
fatal results. Errors cannot be avoided, but their immediate 
correction is a necessity. 

371. This feeding chart contains all those items which 
the writer has found necessary in feeding, and which mothers 
show they do not know, but are anxious to learn. It is an 
explanation of those facts which mothers have asked for and 
which they have no opportunity of learning in any other way. 

372. Experience shows that those who fill these charts 
regularly soon become verv expert and rapid in detecting 
every change in their babies and also feel independent of 
those absurd advices and suggestions which are showered 
upon all mothers. Mothers thus educated can avoid nearly 
all the serious infantile sicknesses and become the most 
expert nurses when sickness does overtake them. 

373. The filling of these charts educates any mother 
thoroughly on all the foods and how to use them so as to 
obtain the best growth and nutrition of her children. Its 
benefits are applicable to children of all ages. 

374. The advantages to the mother in using the feeding 
chart are very numerous. They are as follows: 

144 



THE FEEDING CHART 145 

1st — The persistence of correctness in work. 

2d — Exactness in the amounts of each food used daily 
and in the size of the meals given to the infant. 

3d — Concentration of thought on the points essential and 
necessary for success. 

4th — Attention to details in all parts of the work. 

5th — Its educational advantages for present and future 
use. 

Gth — A daily reminder of the importance of each feature 
in feeding an infant. 

7th — The independent spirit and self-confidence which it 
inspires in the mother who fills the chart regularly, as it 
protects her from the importunities and advices of her 
friends. 

8th — The easy recognition of errors made and how to 
correct them. 

9th — The daily record of the exact condition of the child 
at any time. 

10th — The avoidance of sickness due to digestive errors. 

11th — Knowledge and experience thus gained by the mother 
enables her to prevent many sicknesses in the future and 
shows her how to feed and nurse her children when they are 
not in good health. 

375. While the filling of the chart is a little confusing 
for the first two or three days, the necessary thought which 
it demands when filling it daily soon makes this work very 
simple and pleasant, and as it compels the mother to watch 
all the details in the infant's daily progress, she quickly be- 
comes familiar with the work and finds her success unavoid- 
able. 

376. When the mother sees that, in recording the results 
of the food as shown in the stools, weight, sleep, rest, etc., 

10 



146 FEEDING RULES FOR INFANTS 

she is compelled to think of the reason for every unfavorable 
answer, she asks herself the question, "Why should not this 
be as favorable as it was yesterday?" After worrying in 
this way two or three times, the answer always comes to her 
readily when she looks at the changes made in the food or 
the size of the meals on the previous day. It is thus almost 
an impossibility for an intelligent woman to go wrong in 
feeding a healthy child if she is careful to thoroughly fill 
the chart each day. The careful anxious mother is re- 
minded of each and every error she has committed inside of 
twenty-four to thirty-six hours from the time it is made. 
In this way, it is almost impossible to continue an error 
longer than one or two days at most. Errors made in this 
way can only be small ones and are easily corrected, as the 
mother can always go back to the last day with a correct 
formula and good results (220). 

377. Each chart is divided into seven columns to be filled 
with the dietary and child's progress for seven successive 
days. It is requisite for the mother to fill out all the items 
in each column daily, and not at any time get into the habit 
of marking ditto, ditto — simply because it was the same as 
the day before. This is important, as it compels attention 
to each feature and demands daily reminding on important 
points. The reading of the filled lines across the whole seven 
days of the chart shows at a glance what the alterations 
have been during the last week and whether the results have 
been satisfactory or unfavorable. When a mother becomes 
indifferent to the necessity of filling out each column com- 
pletely, it is altogether probable that she is not watching her 
work carefully, and that errors will soon creep in and the 
infant be more or less seriously damaged by her omissions. 
It has been the experience of the writer that all successful 



THE FEEDING CHART 



147 



mothers take great pleasure and keen interest in filling out 
each column daily, but where they have neither enthusiasm 
nor time enough to do this, they should not have charge of 
the infant's dietary and care. The future health and growth 
of the little one are of such paramount importance that 
every person engaged in this work should feel the great 
necessity that exists of omitting nothing that can be done 
for the infant's future success, and that success will not be 
assured by anything less than the fullest attention that can 
be given to all the details of this very important duty. Any 
mother who does this honestly and continuously will not be 
robbed of the privilege of showing a fine, healthy, vigorous 
baby, equal, if not superior, to that of her neighbors (171). 

FEEDING CHART 
Name Residence Age 



1. Year, 1905 

Month, Aug 


10 


11 


12 


13 


14 


15 


16 


2. Cream 
















3. Human Milk 
















4. Skim-milk 
















5. Whey 




















6. Lime-water 
















7. Boiling water. . . . 
















c ( cane 

8 ' Sugar Imilk.... 






























|9. Starch 
















10. Unused Food 
















( Albumen 

11 J Beef Tea 

( Beef Juice 
















12. Feed How Often . 
















13. Day Meals i No. 
















. 6 A. M. \ 

to 6 P. M. ( Size . 












• 




14. Night \ No. 

Meals "j Size. 
















15. WholeDay'sFood 
















16. Spits. 
















Vomits 























148 FEEDING RULES FOR INFANTS 

FEEDING CHART— Continued 



17. Whole Number 
of Meals 



18. Medicine 



19. Number of Stools 



20. Color 



21. Odor 



Natural. 
Foul 



( Splashy 

22. Kind] Soft 

( Formed 



23. Colleges. 



24. Weight 



<?\ Has i Natural. 



2 ^Gas|UP wn 



27. Sleep | ^ 



» Temper ) good. 



29. Hungry ( How 
Before < Many 
Meals f Minutes 



30. Temperature 



lt% \ Natural. 
31. Unne| StrQng 



32. Genitals. 



33. Abdomen 



34. Skin 



35. Head 



36. Veins. 



37. Flesh 



38. Bones. 



378. Item No. 1 — Date. This requires the year, month 
and day to be recorded. 

379. No. 2 — Cream. Fat is utilized for heating purposes, 
the surplus amount being deposited underneath the skin, 
thus rounding up the child, adding beauty and symmetry 
to its appearance. One of its main physiological duties is 
the lubrication of the bowels. This secures a continued 



THE FEEDING CHART 149 

softness of the stools and prevents a dry, constipated con- 
dition (243 and 383). 

380. Human and cow's milk carry the same proportion 
of fat — about four per cent., varying in extreme cases from 
three to five per cent. 

381. A quart of milk, when thoroughly cooled on ice at 
a temperature of 40 degrees, from twelve to sixteen hours, 
will yield about six ounces of cream (566). Of this cream, 
the infant will consume during the first few days of its life 
from two to eight teaspoonfuls daily. It may be increased 
rapidly during the first month (240). 

382. Cream, like milk-su^ar, is digested in the upper 
part of the digestive tract immediately below the stomach; 
but where it is fed in excessive amounts, or rather in 
amounts beyond the power of the digestive glands, decom- 
position results, causing nausea and vomiting. This 
feature should always be borne in mind, as it will explain 
the vomiting of meals or a large portion of the food taken at 
any meal (300). 

383. A very popular belief is that cream relieves con- 
stipation. This causes many mothers to feed it in excess, 
not knowing the damage they may cause by so doing. 
When moderate increases of one teaspoonful daily fail to 
soften the stools or to move the bowels, further increases are 
useless for this purpose and likely to be injurious to the 
digestive power, Few infants weighing from fifteen to 
eighteen pounds can digest perfectly more than three to four 
ounces daily (243). 

384. It is also thought by many that the cream, or fatty 
part of milk, is the richest and best food for infants; conse- 
quently, very great errors are being committed by mothers 
and nurses in their desire to give an unusually good nourish- 



150 FEEDING RULES FOR INFANTS 

ing food to the infant. By following this idea they feed it to 
such an extent that it soon shows decomposition and causes 
disturbed sleep, restlessness, foul greasy stools, loss of 
weight and frequently fever also (211). 

385. When cream is fed in proper proportions, the 
stools will retain considerable form. When it is fed too 
freely, the infant will be gassy, cross and uncomfortable 
and the stools will become soft, greasy, battery and smell 
very foul. 

, 386. When fat ferments in this way, it forms acids which 
are irritating and injurious to the fat digesting glands and 
the continuation of this excessive error will, in a short time, 
destroy or reduce their secretions and thus check the child's 
development and growth for many months or, possibly years. 
In some cases of extreme irritation, the power to digest fat 
is permanently reduced (300). From this will be seen the 
great importance of so regulating the amount of fat in the 
infant's dietary as to secure perfect digestion with natural 
stools and thus avoid these bad results (243). 

387. We must remember that nature has only provided 
for four per cent, of this particular element in the human 
milk diet, and where an excess is great, it must either be 
carried off by the stools or decompose in the digestive tract 
and cause sickness. 

388. No. 3 — Human milk. In prematurely born infants, 
those with imperfectly developed digestive powers and those 
whose digestive glands have been damaged by improper feed- 
ing* great difficulty is commonly found in framing a substi- 
tute dietary which will make them happy, sleep well and in- 
crease in weight. These cases should receive human milk 
for at least a portion of their regular dietary. Too much 
importance cannot be placed upon this necessity, and it 



THE FEEDING CHART 151 

should be kept constantly in view when feeding infants of 
this character (108-201). 

389. No. 1 — Skim-milk. This is the most important 
item in the infantile dietary. It carries all the proteids, 
both soluble and coagulable, which are necessary for the 
infant's growth, development and strength and also four and 
one-half per cent, of sugar necessary for heating purposes. 
Out of these proteids, all tissues, muscles and fibers are 
made and the growth of the infant secured. They exist in 
human milk in about one and one half per cent, and in 
cow's milk in three per cent, to four per cent. (150). 

390. Skim-milk, in infant feeding, is analogous to meat, 
eggs and cheese in the adult diet. It usually has a con- 
stipating effect, but when it carries a fair proportion of fat 
or cream, this constipating influence is lessened or perhaps 
entirely overcome (560). 

391. The amount of milk necessary to add to the solution 
for the daily food varies from two ounces in the infant four 
to six weeks old to twenty-six ounces in the infant nine or 
ten months old. Enough must be fed to give the stools 
formation, and advances in milk for the infant that is grow- 
ing properly must not be more than two to three teas- 
poonfuls each week for perfect feeding (231). See schedules 
573 to 579. 

392. Where skim-milk is fed too largely, it may pass 
through the infant only partly digested, making dry, crumbly 
stools, but will most commonly appear in the shape of curds 
in connection with either well-formed stools or soft, splashy 
ones. Usually, the stools will be partly formed and the rest 
of a watery character with foul odors. The infant in this 
condition will be cross, restless and unhappy. These curds 
look like beans, peas or pieces of leather of any shape or size, 



152 FEEDING RULES FOR INFANTS 

yellow on the outside, white internally and difficult to break 
with a match. They are the only hard substances ever found 
in the milk stool, and when once seen, are quickly recognized. 
A match should always be used to prove that the substance 
in the stool is actually a curd until the mother becomes 
familiar with its appearance. 

Where overfeeding is done, the lining of the bowels is 
irritated by decomposing food. This causes extra mucous 
secretions which surround little grains of stool as they are 
formed in the upper bowel, and these appear to the inexper- 
ienced mother or nurse like curds. These little yellow grains 
of stool are very numerous, always soft and easily rubbed 
out with a match, thus proving they are not curds. This 
heavy coating of mucous prevents these little lumps or 
grains of stool from coalescing and forming a natural- 
shaped stool. 

393. An additional way of distinguishing between curds 
and these small granules of stool surrounded by mucous is 
by their number and size. Curds seldom exceed two to six 
in any stool and never show uniformity in size or shape. 
They are mostly of the large bean or pea size and have ir- 
regular outlines. The particles of stool surrounded by 
mucous, which are so generally mistaken for curds, are 
usually very numerous and may vary from fifty to hundreds 
in one stool. They are alwa}^s small and mostly uniform in 
size, being about the size of a grain of mustard, wheat or 
rice. In occasional cases they are more numerous and cor- 
respondingly smaller, being not larger than a pin-head. 

394. Damages produced by feeding skim-milk in excess 
so that curds appear in the stool are very serious and ex- 
ceedingly hard to repair or correct when allowed to continue 
long. Very commonly the power to digest skim-milk, 



THE FEEDING CHART 153 

when this occurs, is very much reduced or perhaps entirely 
destroyed (251) and it very materially increases the difficulty 
in feeding the infant, especially when it is very young. In 
children six or eight months old, who are able to digest starch 
this error is not such a serious one as in the younger infants. 

395. No. 5 — Whey is a portion of the milk obtained by 
coagulating the casein or cheesy element, with rennet or sherry 
wine. It may be made from either whole milk or skim -milk 
and is that portion left when the casein has been removed. 

396. When made from whole milk, it contains fat, liquid 
proteids and milk-sugar. When made from skim-milk, it 
contains all these foods except fat, and this form must be 
used where an infant cannot digest cream. 

397. Whey is a weak mixture of foods suitable to infants 
in convalescence from sickness, especially to those who have 
been overfed on skim-milk and their digestion of casein 
somewhat damaged. It is a very valuable addition to the 
diluted cream in infants a few weeks old who are not thriving 
properly on the cream mixture. 

398. No. 6 — Lime-water. As milk gradually develops 
more acidity in proportion to its age, it very frequently, on 
this account, retards digestion and irritates the stomach of 
the young infant, thus causing colic or vomiting. This is 
usually overcome by the addition of lime-water to the milk 
before feeding. Where lime-water is not added to cow's 
milk the infant may suffer from indigestion with consequent 
colic, crossness and disturbed sleep. There is not much need 
for lime-water in the winter season as cold weather checks 
bacterial life and consequent souring of milk. Lime water 
cannot be added when milk requires to be predigested. 

399. There is great diversity of opinion regarding the 
amount of lime-water which should be used, but, usually, it 



154 FEEDING RULES FOR INFANTS 

is unnecessary to add more than one to four ounces to the 
milk for the whole day. More than that amount may be 
given with safety, but the above quantities are enough to 
neutralize this extra acidity in the milk (208), and greater 
amounts reduce the digestive power. The larger amounts 
of lime-water should only be used in hot weather. Some 
infants may be fed without lime-water. 

400. As lime-water can never increase in strength by 
age, it is always safe to use it in the same amounts, whether 
it is three days or. three years old. Water will only dissolve 
so much lime, no matter how long they are mixed or how 
much there is present of either of these articles. 

401. Boiled water and building lime, mixed together in 
any proportion, so long as there is enough of each one, will 
make good lime-water. The water can be poured off after 
standing three or four days, bottled till needed and more 
water added to the lime. 

402. No. 7 — Boiling water. In order to remove all im- 
purities in water, it is necessary that it be filtered or boiled. 
It is also necessary to dissolve the milk-sugar in the water, 
while boiling, in order to obtain a perfect and sterile solu- 
tion of the sugar (206). It is not desirable to mix hot water 
with milk except during hot weather, when all milk should 
be pasteurized or sterilized to prevent bacterial growths and 
consequent souring. These processes also prevent the 
diarrheal diseases of the summer season, if children are not 
fed too much. They should always be tried when children 
are colicky and do not thrive well. 

403. No. 8 — Sugar. This, like fat, is a heat-forming 
element in the human economy and the surplus amount of 
it in the food is utilized in fattening the child and giving it 
a rosy color. Nature delights in sugars, as shown by 



THE FEEDING CHART 155 

the analysis of human milk. If, out of the twelve and one- 
half parts of solids in one hundred parts of human milk, 
seven parts, or more than one-half of the food, is made up 
of sugar, her preference for this food is very apparent. 
Human milk contains seven per cent, and cow's milk four 
and one-half per cent. The sugar solution forms the basis 
of the food and all additions of cream (fat) and skim-milk 
(proteid) are made thereto. 

404. The prejudices of some people prevent sufficient 
feeding of sugar, but indigestion and poor nutrition follow 
the exclusion of this article from the dietary of the infant; 
in fact, the child cannot thrive, look well and rosy if it does 
not receive a fair proportion of this food in its daily dietary. 

405. Great diversity of opinion exists regarding the 
suitability of milk-sugar and cane-sugar for infantile feed- 
ing. Many of our best physicians are divided on this point. 
In this, as in many other matters disputed, perhaps the 
happy medium may and will give the best results. Accord- 
ingly, it is desirable, after having reached the highest point 
in milk-sugar which is suitable to the infant, to make 
farther additions every few days of one teaspoonful of 
granulated sugar to the whole day's dietary. As soon as all 
sugars show the usual sign of fermentation, as described in 
409, all increases thereof should be stopped and farther 
additions to the dietary made in the fat or proteids, but this 
should not be done before proving that all sugars — milk, 
cane and grape (malted starches) — ferment in each case. 

406. As cow's milk contains only four and one-half per 
cent, of sugar, it is necessary, when feeding it, to add enough 
sugar of some kind to make up the shortage of this element 
in the food mixture. 

407. The young infant, during the first ten days of its 



156 FEEDING RULES FOR INFANTS 

life, does not require as much of" this article as it does when 
older. One half an ounce of milk-sugar added to eight 
ounces of boiled water makes a six per cent, solution which 
is strong enough for a new-born infant, and when added to 
seven ounces of water, makes a seven per cent, solution, the 
usual strength necessary for an infant over ten days old. 
\- 408. The usual strength of milk-sugar required for in- 
fants over a month old is one ounce to every twenty ounces 
of the food mixture. When infants digest it well, this may 
be increased to one ounce in every eighteen, but where it 
shows any irritation, it must be changed to cane or grape- 
sugar or reduced to one ounce in twenty-five or thirty ounces, 
or even less for a short time, but success always demands 
that it be fed from one-eighteenth to one-twentieth of the 
whole food mixture when it is well digested. Granulated 
sugar, when used in place of milk-sugar in hot weather, does 
not ferment so quickly. When granulated sugar is used, 
only one half the above amounts is needed, but during the 
first six months, milk-sugar should always be preferred 
when it agrees with the infant. 

409. Overfeeding sugar causes gas, colic, restlessness 
and uneasiness. In this condition, the lining of the bowels 
becomes reddened and irritated, the redness showing ex- 
ternally around the rectum and in severe cases around hips 
also. Unless the amount of sugar is reduced when this 
appears, frequent watery, splashy stools with much gas and 
foul odors will soon follow and the power to digest this 
article will be more or less reduced (214). 

410. Infants very seldom continue to fail in digesting 
sugar for any length of time. Usually a moderate amount 
of some kind can be given, but when it has been fed in ex- 
traordinary amounts, damage is done thereby. Experience 



THE FEEDING CHART 157 

shows that, even in these cases, by lessening the amount, 
changing the kind or combining two together, it may be con- 
tinued in the dietary to a moderate extent at least, and careful 
use thereof within the bounds of perfect digestion so soon recu- 
perates the digestive glands that it can be gradually increased, 
so that, in a few weeks, the usual seven to eight per cent, 
which the child originally consumed can be successfully given. 

411. We have no substitutes, either in the animal or 
vegetable kingdom, which will take the place entirely of 
sugar, especially during the first three months of the child's 
life. As soon as the infant is able to digest a small portion 
of starch, this food can be added, and when necessary, 
gradually substituted for a portion of sugar (215). 

412. When it is found necessary to add starch to the in- 
fant's dietary, the amount of sugar in the food must soon 
be reduced. As starch and sugar are both digested by the 
same glands (starch being converted into sugar in the 
process of digestion), the addition of starch without a re- 
duction in sugar often produces fermentation. The approach 
of this is always recognized by the redness which appears 
around the child's rectum and also by the extra gas or 
splashy character of the stools. The reduction or change in 
sugar is unnecessary before the gassy condition or redness 
of the rectum indicate imperfect digestion and fermentation 
(306). 

413. Milk-sugar should be bought of reliable quality, 
such as Merck's, Mallinkrotz' or Squibb's. These grades are 
all finely pulverized and will require to be packed down close 
in the measure with the ringer in order to obtain the full 
weight required. Ordinary commercial milk-sugar is 
cheaper than the above, but is liable to be adulterated. 
Milk-sugar should always be dissolved in boiling water, and, 



158 FEEDING RULES FOR INFANTS 

where it shows sediment, the solution will require straining 
before being fed to the infant. 

414. No. 9 — Starch. In infant feeding, this should be 
prepared according to directions (329). Where starch-water 
is used for very young infants of one to three months of 
age, one teaspoonful may be added to two or three bottles 
each day as a commencement of this food (304). If it shows 
no extra gassy condition and consequent colic, it may be 
gradually added to all the bottles after a two days' trial, and 
if it continues to show no disturbance in the digestion, the 
amount of starch water can be increased every two days. It 
is never safe to make additions to all the bottles in any one 
day. These additions of starch-water will demand corres- 
ponding reductions in the amount of boiling water used in 
making the daily food. It will soon also demand reductions 
in the sugar, as before directed (412). It is very often sur- 
prising to see how much starch can be added to the infant's 
dietary before any appreciable increase is seen in its weight. 
As long as the weight does not advance too rapidly and no 
disturbance is shown, these additions can be repeated. The 
form of starch suited to the infant must be selected according 
to previous directions (324). 

415. Where dry crushed starches, such as flour, flakes 
and proprietary foods, are used instead of the grains, they 
can be increased by half or one teaspoonful amounts every 
two, three or four days. These forms must be boiled from 
one half to one hour in the water needed for diluting the 
milk (330). 

416. No. 10 — Unused food. By carefully measuring the 
amount of prepared food not fed to the baby, the mother 
always has a record of the whole amount given daily, 
and in this way, can check any mistakes which may occur 



THE FEEDING CHART 159 

either in the amount of food given or the intervals between 
meals each day. Where it is necessary to increase the whole 
amount of food prepared in order to have a sufficiency for 
the growing infant, all increases in the different foods and 
water should be shown in their respective places on the day 
in which they were made. When these increases in amounts 
are necessary, the chart record cannot be reliable when they 
are not shown at the correct time. They usually are enough 
to make one or two extra bottles and can be shown by 
adding one-eighth, one-sixth or one-quarter to each item. 
There should at least be enough food made each day for 
one extra meal, to meet any accident to the bottles. 

417. No. 11 — Albumen, beef tea and beef juice. These 
three articles represent the animal proteids which are 
commonly used as substitutes for or additions to the proteids 
in skim-milk. They are not equal to the milk proteids in 
their power to nourish and develop an infant, but can be 
used as partial substitutes for infants whose digestive glands 
have been damaged by excessive or unsuitable milk proteids. 
It commonly happens that these injured digestive glands 
refuse entirely, or in part, to digest milk; consequently, egg 
or meat proteids must be used as part or the whole food of 
that kind (213). 

418. Where it is necessary to use these new forms of 
proteid, they should be commenced in small quantities and 
the amount gradually increased as long as the stools show 
healthy formation and give no evidence of irritation by their 
soft mucous character or foul odors and extra frequency. 
For the mode of preparing these proteids, see 785, 786 and 
788. It must be remembered that most meat proteids will 
give a dark color to the stool and urine, and always a 
stronger odor also. Few infants can consume more than' 



160 FEEDING RULES FOR INFANTS 

two to three ounces of beef juice or egg-water daily. Softly 
boiled egg is more perfectly digested by infants than the egg- 
water, when they are old enough to take it in this form from 
a spoon. 

419. No. 12 — How often should an infant be fed? This 
is a very important subject. The time chart, showing inter- 
vals between meals at different ages, in No. 441, is only a 
general guide applicable to most healthy children with per- 
fectly developed digestive glands, when their diet is correct 
in quality and amount, but it cannot apply to infants who are 
improperly fed, and, consequently, show unhealthy stools. 

420. Mothers are usually anxious to increase the size of 
the meals and also lengthen the intervals between feedings* 
This is desirable when it can be done successfully; but what 
does success mean on this subject? 

421. Success means to do this and not disturb the infant's 
sleep, happiness or digestion in any way. When these 
increases in meals make the infant gassy, cross and restless, 
or the stools foul odored and softer than formerly, the 
change is an error (376). 

422. Children with weak digestive powers must be fed 
small meals frequently, and vigorous digesters can take 
larger meals at longer intervals. 

423. The main idea is that every infant must have the 
largest amount of food every twenty-four hours that it can 
digest perfectly. If it is a poor digester and very restless, 
with soft or foul stools, the meals must be at fixed times 
and small enough to be perfectly digested, showing correct 
stools (272). This will necessitate meals frequent enough 
to introduce the amount of food needed for perfect nutrition 
each day, if possible. 

424. Following out this principle allows the good digester 



THE FEEDING CHART 101 

to be fed when he becomes hungry and to take his full 
amount of food each day in six or eight meals, while the poor 
digester, of the same weight and requiring the same amount 
of food, must be fed at a fixed hour and may require his diet 
divided into sixteen or twenty meals given at short intervals, 
before he can succeed (230). 

425. This necessitates feeding infants, who digest well, in 
a somewhat irregular way or when they become hungry, as 
good nursing mothers always do, because the nursing infant 
does not always take the same sized meal, and thus becomes 
hungry at irregular intervals; but the infant with foul or 
unhealthy stools is always getting more of some food than 
it can perfectly digest. This result demands a fixed time 
between meals until changes in quality or amount of food 
have corrected this indigestion and produced healthy stools. 
When this has-been secured, he also can be fed when hungry, 
as he is now happy and laments only when hungry. Formerly, 
his cries indicated indigestion rather than hunger and were 
no guide for feeding. 

426. Nos. 13 and 14. This refers to the number and size 
of the meals used, and is a subject which always requires 
very careful consideration. 

427. During the first month, the healthy infant will re- 
quire its meals every one and one-half hours in daytime and 
every three to five hours through the night. With very 
nourishing and easily digested food, the feeding will be less 
frequent at night, as the meals can then be larger. After 
the first month or six weeks, the healthy infant will not 
require to be fed oftener than every two hours in daytime, 
every four to five hours at night and less frequently as it 
grows older. Extensions of time between feedings will al- 
ways follow with the infant who is properly nourished until, 

li 



162 FEEDING RULES FOR INFANTS 

at six or seven months, it will pass the whole night without 
being fed and the intervals between day meals will be three 
to four hours (441). 

428. The poorly developed infant and also that one whose 
digestive glands have been damaged by an improper dietary 
will require their meals reduced in size and increased in fre- 
quency just in proportion to the imperfection and the 
damage received. Some of these infants will require to be 
fed every hour in daytime and probably every two hours at 
night. In very severe cases, it is occasionally necessary to 
feed as frequently at night as in daytime. This, of course, 
demands very small meals. This necessity for very fre- 
quent meals usually continues only for a limited time. 

429. In all infants, whether healthy or damaged, when 
the food has been properly adjusted to suit their digestive 
power, it is desirable to feed two different sized meals dur- 
ing the day. When large and small meals are given regularly 
every day, the mother can always notice which sized meal is 
most suitable to the infant and gives the greatest comfort, 
and she can then feed more meals of the suitable size. Ac- 
cording to this plan, it is always necessary to have at least 
two large or two small meals given every day and the results 
shown by the infant will guide the mother very largely in 
the future sizes and the amount of food which is most suit- 
able to the infant's digestive power. This plan makes the 
child happy while awake and gives comfort and continued 
sleep during the night. These meals should vary from one 
half to three quarters of an ounce in size. 

430. Nursing mothers always recognize the difference in 
the size of the meals which their children take when they 
are healthy. No mother will tell you that her infant always 
nurses the same amount at each meal. Her universal testi- 



THE FEEDING CHART 163 

mony is that the infant, at times, will take large meals, and 
at other times, she will say that it is not hungry, as it did 
not nurse much. This applies to all humanity. We all 
know that there are variations in the amount of food which 
we consume at different hours of the day. As the nursing 
infant varies in this way, is it not reasonable to suppose 
that the hand-fed infant should be given the same privilege? 
It seems only prudent to give the infant the same relief that 
we all claim when we have taken an unusually large Sunday 
dinner and then entirely refuse our evening meal, or at most, 
make it a very light one indeed. 

431. Where only one sized meal is fed, the complaints of 
the infant are nearly similar all the time, and there is often 
great difficulty in deciding whether the infant is receiving 
too much or too little food. It is a very common thing, 
then, to mistake complaints resulting from hunger for those 
made when the child is suffering from colic. On this point, 
mothers continually complain of their inability to realize 
exactly what is wrong, but different sized meals remove this 
uncertainty by showing which sized meal gives the most 
comfort. The complaint from hunger usually results 
from the small meal and that from indigestion and colic 
from the large meal (473). 

432. The sameness in food, as well as the amount 
thereof, is not conducive to that stimulation of the stomach 
which will be obtained by occasional large meals, demanding 
extraordinary effort on the part of the stomach to properly 
digest them. Nature has made provision in all the glandular 
organs of the body to perform extraordinary labor at times. 
This is accomplished by an extra supply of blood to those 
glands when they are called upon to do this extra work; but 
as the rule in this is the same as in other parts of the body, 



1C4 FEEDING RULES FOR INFANTS 

extraordinary effort should be followed by corresponding 
rest (210). 

433. When a one sized meal is continuously the rule, the 
great danger is that, in the desire to feed the child all it can 
digest and make it grow rapidly, all the meals will be so in- 
creased as to permanently reach the point of always giving 
too large meals. This is the actual condition which we con- 
tinually meet in hand-fed children and is what causes so 
many infants to suffer from colic, gas and foul, frequent 
stools, and is also the cause of marasmus which kills thou- 
sands of children every year (289). 

434. The rapid increasing of meals or sudden change of 
food imposes extra burden or labor on the digestive glands 
which they strive to accomplish, and, in so doing, demand 
an extraordinary supply of blood. This extraordinary 
circulation in these glands is steadily increased by their 
efforts to digest too large meals until this circulation reaches 
an inflammatory point, when nearly all the secreting power 
of these digestive glands -is checked or lost. At this point, 
and from this condition, we have attacks of acute indiges- 
tion, fever and vomiting which commonly result in diarrhea 
or dysentery. 

435. By using different sized meals, these digestive 
glands are rested after doing extraordinary labor and the 
happier condition of the infant with less gassy eructations 
from the stomach or discharges from the bowels, and, con- 
sequently, better sleep clearly show the mother that the in- 
fant is more comfortable on some small meals than it is 
when all meals are made large. 

436. In this way, the mother is continually being edu- 
cated regarding the ability of her infant to digest its food, 
the size meals it can digest with comfort and the benefits it 



THE FEEDING CHART 165 

receives from resting the stomach with smaller meals at cer- 
tain hours of the day. The mother can also see that the in- 
fant's digestive power is continually being stimulated and 
the stomach gradually developed by extraordinary efforts 
followed by periods of rest. 

437. The night meals, in young infants, during the first 
six months, should always be from one half to one ounce 
larger than the largest day meal. This ability to take larger 
meals is due to the fact that the long hours of sleep afford 
more time for digesting the food, and the very empty con- 
dition of the stomach after a long sleep demands a larger 
meal in order to satisfy the increased cravings of hunger. 
When an infant does not receive these large night meals, it 
will awaken more frequently and demand a greater number 
of meals. An infant during the first six or eight months 
can always digest larger meals at night than in the daytime. 
This, of course, applies mainly to infants who are fed properly 
during the daytime (429). 

438. It must not be thought from this that large meals 
are all that is necessary to secure good sleep at night. It 
is equally important that the infant receives its full number 
of meals during the daytime, even if it has to be awakened 
in order to take them. The infant who is not fed regularly 
in daytime does not receive sufficient nourishment to pre- 
pare it for the night, and, consequently, will awaken fre- 
quently and demand extra feeding to make up for every defi- 
ciency during the day hours. Just as the mother takes her 
meals regularly and consumes a regular amount of food daily, 
so must the infant do likewise. Enough food is demanded 
every twenty-four hours to nourish the body. If it is not 
given in daytime, disturbed sleep demands it during the night. 
This rule applies to nursing as well as hand-fed infants (84). 



166 FEEDING RULES FOR INFANTS 

439. Where healthy infants are allowed to be hungry 
only five or ten minutes before the next meal during day 
hours, they very soon commence to refuse night meals. 
When night meals are refused by infants, special care must 
be taken to see that this amount refused at night is 
gradually added into the day meals. If this is not attended 
to, the infant will very soon demand the night meals again. 
About three days are necessary to transfer a night meal 
into the day meals. 

440. Infants vary considerably in the rapidity of their 
digestion at different hours of the day, and the intelligent 
mother very soon recognizes those hours where it is desirable 
to vary the time of feeding a little or vary the size of the 
meal in order to secure that amount of sleep necessary for 
the child's happiness and comfort. 



THE FEEDING CHART 



167 






3 



c 
<v 

a 



00 



cd 



ID 
C 
rd 



CD 



t- (L) 



tuo £ 



cd cd 






cd 

.a 

'S3 



. feu 

cd 







^ 




* 


X 


St 


^ 




*» iw 


b- 


00 


OS 


CM 


kO 


00 


S3 


ill Sui 
.bies o 

'ounds 


O 


3 


3 


3 


1— t 


- 


£a * 




^ 


^ 


^ 


^ 


^ 


^ 




fc- 


t- 


00 


OS 


CM 


iO 


00 


u 
















O . 


lO 


o 


CM 


CO 


00 


CM 


iO 


"** 2 <" 




CO 


CO 


CO 


CO 


"tf 


^ 


•a ° c 


o 














CS 3 


+ J 














2 *■ O 

a* 


o 


iO 


CM 


Tj< 


00 


CO 


b- 


»H 




CM 


CM 


CM 


CO 


co 


< 


5 * 


& 




^ 


^ 


^ 






« 


C . 3 


T— 1 


CO 


CO 


""* 


vO 


fr- 


00 


s 


O 














< 


'i s .° 


« 














w 


Q * 


y—i 


CM 


CO 


Tj< 


Hi 


CO 


t- 


ft 

o 


vo 
































>< 


15 


& 




X 


X 


^ 


^ 


\N 


H 


Jh \0 V 


»H 


CM 


CM 


CO 


"* 


o 


co 


< 


J? • 3 


o 














3 o 




s 








^ 


^ 


o 




,H 




CM 


CO 


^ 


"^ 


iO 


01 ° 
















-w M *! '"J 
















•° c S 2 
.2 3 . . 


CM 


CM 


_ 


I— 1 


1— ( 


o 


o 


£ 8 * < 
















fa © ^ 
































— COT 
















erva 
:wee 
ding 
ours 


X 


^ 




^ 






^ 




T-l 


CM 


CM 


CO 


CO 


CO 


C 3 SW 
















H «h 
































O •- OT 
















i- °> £< 
fc u 3 

J3 c ° 


o 


o 


os 


00 


t- 


CO 


IO 


g^s 


T— ) 


1-1 












3 SJ ■* 
























X 
































c 
















o 

s 










>, 


^' 




XI 








OS 




3 


Ih 


■*-> 

c 
o 


2 


s 


M 


•♦-> 

C 


*3 

Ih 


X 


2 

o 


s 


J3 




< 


> 


s 


.* 


.2 




*a> 




<u 


" 4 -' 


'S5 


^d 


*s 


g 




en 


o 


o 


<u 


*tn 






O 


*■* 






O 


„ 


w 






*T3 


X 


■*-• 


" 


" 




Ih 


s 
o 


V- 

O 


.C 


•a 

Ih 


J 


XI 




r-< 




"H 


!S 


K 


c 


1 




H 


I/} 


fr 


175 


H 


U) 


2 



168 FEEDING RULES FOR INFANTS 

442. The above meals of bottle food will generally contain 
only milk solution during the first three months. During 
the second three months, they will also contain a starch 
solution with the milk (304). From the sixth to the ninth 
month, there must be a liberal addition of starch to the 
mixture and some bread and cracker crumbs (303), and dur- 
ing the last three months, in addition to the starch and milk 
solution in the bottles, infants must be taught to eat bread 
crust, crackers and other solid starchy foods in increas- 
ing quantities as they become older (771). It will not be 
necessary at any time to increase the bottle food more than 
above shown at the twelfth month, as all increases in food 
after twelve months must and should be entirely in the line 
of solid articles, so that the healthy infant at fifteen months 
will be on a practically solid dietary, only drinking the 
necessary amount of water and milk requisite, but not in 
excess of what it took when a year old (735). 

443. No. 15 — Whole days food. This is a very important 
and useful space to fill in daily, as it shows at a glance what 
changes are made in the amount of food. This becomes a 
valuable check upon those irregularities in feeding which al- 
ways mean failure, such are those that show variations up 
and down of one to three ounces daily. 

444. When the child is progressing satisfactorily, the 
increases will be very gradual, or there will be no increase 
whatever when any one of the items 2, 3, 4, 8, or 9 show an 
increase or when the 7th item shows a decrease; in other 
words, for success in infantile feeding, the chart of a grow- 
ing infant must never show more than one change in any 
one day. By following this rule, the error which follows a 
mistake can always be traced to its origin and corrected 
(376). Where two or more changes are made in any one 



THE FEEDING CHART 169 

day and the stools show that an error has been made, it is 
impossible to know exactly which change has caused the 
error. Only in underfed infants with healthy stools is it safe 
to make additions to the dietary in more than one point in 
any day. 

445. Where, then, increases are made in item 15, they 
must not be greater than will give correct increases in 
cream and milk ('240 and 241). 

44G. When irregular feeding is indulged in and the 
number of meals varies daily, these figures showing the 
amounts of food fed will at once warn the careful mother of 
the enormity of the error she is making. 

447. No. 1G — Spits. Spits is commonly used by mothers 
to explain that small amount of food returned occasionally 
by the infant whose stomach has been well filled. Mothers 
when asked to explain what amount they mean by this word, 
usually say a very little, half to one teaspoonful. This 
amount usually comes up with the necessary expulsion of 
gas immediately after taking a meal or at some interval be- 
tween meals. 

448. Spitting is evidence of a full stomach and should be 
looked upon as a measure of the child's stomach capacity, 
for it shows that the infant will take care of that amount 
of food which reaches the spitting point, but that more will 
cause vomiting. It is always desirable that mothers feed 
their infants large enough meals to cause this occasional 
spitting, as that is an assurance to them that they are 
feeding the full amount which the stomach can contain. 

449. Very commonly, it will be noticed that this spitting 
is frequently repeated and may amount to vomiting, but 
nothing is brought, up excepting water. Where this is the 

condition, it shows that the food is too dilute and that the 



170 FEEDING RULES FOR INFANTS 

child would thrive better with food containing less water. 
It is not desirable to feed meals large enough to make the 
child continue spitting after every meal, because such feed- 
ing invariably leads to indigestion, colic and disturbance of 
the bowels. 

450. Vomits. Vomiting is usually caused by too large 
a meal or by the too large amount of fat or sugar which 
the meal contains. Vomiting of food implies that the child 
throws up a large portion of each meal and should be 
looked upon, in the hand-fed infant, as an unfavorable and 
undesirable condition. Hand-fed infants who vomit fre- 
quently never thrive well. They always lose a large portion 
of their food and also sacrifice a great deal of the digestive 
fluid required for their proper nutrition. 

451. Vomiting immediately or very shortly after the meal 
is mostly due to the size of the meal (257). 

452. Vomiting from one-half to one hour after the meal 
has been taken usually occurs in large amounts and is due 
to the amount of water, fat or sugar in the food (259). 
This is always an unfavorable condition and leads to poor 
nutrition and a pale, yellow infant when continued. From 
the above, it will be seen that vomiting in hand-fed infants 
always demands lessening in the size of the meals or smaller 
amounts of water, fat or sugar in the meals. 

453. The nursing infant can often continue to vomit 
freely immediately after meals and still thrive well; but the 
hand-fed infant cannot do this. The difference lies in the 
quality of the food. 

454. No. 17 — Whole number of meals. Where the 
mother is experienced in feeding her infant there is no 
necessity for this item, as such a mother never changes the 
number of meals fed each day to her infant excepting to 



THE FEEDING CHART 171 

lessen them gradually as the infant grows older and thrives 
satisfactorily. To the inexperienced mother, it is desirable 
that this item be filled in regularly, so that, in doing so, she 
will realize or see that she is making a serious mistake when, 
for any reason, she has been induced to give an extra meal. 
Regularity in the amount of food (number of meals) is 
absolutely essential for success in a healthy infant. They 
can be varied in size (429), but the properly fed infant with 
healthy formed stools can never be otherwise than injured 
when extra food is given during any day. It is just as 
important that the healthy infant's meals be a fixed number 
daily as it is that the mother's meals be a fixed number each 
day. The mother must expect, when she varies the number, 
that the infant will suffer from the same disturbing 
symptoms that she does herself when she eats more than 
her usual amount of food in any one day. 

455. An occasional necessity for an extra meal, but only 
a small one, may occur. This happens when weaning or 
changing food, and the new food is given very sparingly till 
stools show its suitability. As changes of this kind always 
demand small experimental trials in the beginning to prove 
that the new food is suitable for the infant, it generally 
happens, during these changes, that the dietary is not. suffi- 
cient to nourish the infant properly and the child may be 
unable to sleep continuously. Where the infant acts in this 
way and is not suffering from gassy disturbances, it is evi- 
dent that hunger is the cause. Under those conditions, it is 
always prudent for the mother to give an extra meal from 
one-half to one hour after the previous meal, to the wakeful, 
crying infant. This extra meal should not be the full size 
of the regular meal and is, largely, a test of the child's con- 
dition. Should the infant be able to sleep quietly and com- 



172 FEEDING RULES FOR INFANTS 

f ortably after this extra meal, it shows that the amount of 
food given during the previous da}' or days has not been 
sufficient and will call for a general increase in the size of 
the meals. 

45G. No. 18 — Medicine. With infants properly fed, this 
item needs no attention. With infants whose digestive 
organs have been crippled or damaged from any cause, the 
physician in attendance may order certain remedies and this 
space gives an opportunity to record such medication. . 

457. All the explanations in the previous seventeen items 
relate to the food and proper ways of giving it. 

It will now be necessary to look at the results produced 
upon the infant by the food which it has received. The 
remaining items to be considered will bear upon these 
effects, and from the facts shown in them will be seen 
the correctness or errors which result from the way in 
which the instructions in the previous items have been car- 
ried out. 

458. No. 19 — Number of stools. Here is a result which 
must be carefully and continuously observed for correct 
infantile feeding. 

The nursing infant who is entirely dependent upon its 
mother for its food has frequent stools during the first month 
or two of its life, gradually growing less in number until the 
infant is eight or ten months old, when it generally has one 
or two stools each day. 

459. The hand-fed infant, on properly modified milk 
suitable for its steady growth and development, should have 
only one, or at most, two stools each day after the first 
month. When there are more than this number, infants 
seldom thrive properly (468). Where the stools always 
show formation, there may be two, three or more daily, as 



THE FEEDING CHART 173 

the number of evacuations is not important when the 
quality is correct. 

460. No. 20 — Color. Infants properly fed upon modified 
cow's milk produce stools of light yellow or lemon shade. 
Where the proportions of cream or fat are too high, the 
stools assume a buttery, creamy or greasy appearance and 
are of a soft or ropy character with foul odors (385). 

461. Light or white-colored formed stools usually are 
short of fat, and when dry and crumbly or green and slimy, 
carry too much proteid, that is, skim-milk (263). 

462. Soft, light-colored stools usually carry too niuch 
milk or boiled starch. This color is thought by many to 
be due to an inactive liver, but a reduction in these items 
generally corrects this color (325). 

463. Starchy foods, when well digested, always darken 
the stools (263). 

464. No. 21 — Odor. When food is properly digested, 
there is very little decomposition, and consequently very 
little odor to the gas or stools when passed from the 
bowels. When this natural condition exists, the child 
always grows well and is happy, if it receives enough food. 

465. Where the stool or gas is of a very strong, foul 
odor which permeates the whole room, it shows that, at 
least, a portion of the food is decomposing instead of being 
properly digested. These children also discharge a great 
deal of foul gas which so permeates the room and clothes 
that it is usually thought the bowels have moved. Where 
this condition exists in infants, they are always cross, rest- 
less, sleep poorly and do not thrive well. 

466. No. 22 — Kind of stool. Splashy stools that spread 
all over the diaper are always the result of fermentation or 
decomposition of the sugary or starchy food or some part 



174 FEEDING RULES FOR INFANTS 

thereof. These stools are usually numerous and indicate 
a poor digestion or unsuitable dietary. Children having 
these stools never thrive, and have all the characteristics of 
sickness. They always lose weight and suffer from ab- 
sorption of decomposed food products. Their blood is con- 
stantly in a poisoned condition and their kidneys are always 
strained in removing this poison. Constant feeding of this 
kind usually damages these organs and lays the foundation 
for future diseases (698). 

467. Soft stools. Soft stools, except during the first few 
weeks, are generally foul and more numerous than desirable. 
They indicate an imperfect digestion or unsuitable food 
proportions. These stools seldom allow an increase in the 
weight of the child. 

468. Formed stools. These are usually proof of good 
digestion, and when of the proper density and color, 
guarantee the successful growth and development of the in- 
fant. There are not more than one or two daily and may 
require the use of the soap stick or enema to move the 
bowels. When formed stools are of a white color and are 
crumbly and dry, they show a shortage of fat in the food or 
an excess of proteid or starch. Changes in the food should 
be made in the directions thus indicated to improve their 
color and consistence (263). 

469. The proper consistence of the stool is important. 
It should be about that of cold lard or butter and cut clean 
and square with a match. When it drags in cutting, it 
usually contains too much fat or cream for successful feed- 
ing. Slight variations from this consistence do not always 
mean failure in the infant's growth. When dry and crumbly 
or grainy in character, the diet usually carries too much 
proteid or starch. 



THE FEEDING CHART 175 

470. No. 23 — Colic. This is generally the result of 
fermenting or decomposing food in the bowels. This fer- 
mentation may be caused by too much of all or any one food 
in the substitute dietary or by different external forces 
which produce changes in the mother's milk or in the child's 
digestive secretions. Too much heat or cold and quick 
climatic changes, such as windy exposure, often cause colic 
also. 

471. Where it results from the quality of the mother's 
milk, it may be due to her continuous inability to secrete a 
milk carrying sugar, fat and proteid in proportions suitable 
to the child's digestive power. Faulty milk may be due to 
errors in the food which the mother consumes; to extraor- 
dinary labor on her part; to mental worry; to irregular nurs- 
ing, or nursing too freely; to sickness or exposure to cold, or 
any force which temporarily interferes with or checks the 
proper proportions in her milk. Where the mother's milk 
continually produces colic in the infant, the propriety of 
weaning should be carefully considered. Where a mother 
ordinarily secretes good healthy milk which produces 
healthy yellow stools, colic in the child can usually be traced 
to some error or change in the mother, and as soon as this 
is corrected, the colic disappears. All hand-fed infants are 
subject to colic equally with the nursing infants when errors 
occur in the dietary (39). 

472. Colic often results from an imperfect digestive 
power. Infants, suffering in this way, may be divided into 
two classes: The first of these will comprise infants born 
with weak digestive glands, and the second are those in 
whom sickness temporarily weakens the digestive secretions. 

To the first class belong all those children inheriting con- 
stitutional taints and those with imperfectly developed di- 



170 FEEDING RULES FOR INFANTS 

gestive glands. Among these are the children born of ner- 
vous, dyspeptic, alcoholic or syphilitic parents. Children of 
syphilitic parents are always very difficult to nourish and 
almost impossible to raise without human milk. Many 
children of alcoholic parents and of mothers with poor 
exhausted constitutions suffer much from weak digestive 
power and consequent colic. 

In the second class are those suffering from some disease. 
In almost every sickness there is a reduction of the digestive 
secretions, and unless the feeding is carefully reduced ac- 
cording to this decreased digestive capacity, colic with green, 
mucous stools is sure to follow, very much aggravating the 
original sickness and thus decreasing the child's prospect 
of recovery. 

473. There is one condition which is very frequently 
confused with the colicky one and which simulates colic 
more closely than any other. This is the complaint which 
the child makes when it is hungry. In the hungry condi- 
tion, the child's motions are somewhat similar but not so 
violent as in colic, and the crying is not of the decidedly 
spasmodic and intermittent type. The cry of the hungry 
child may be loud and strong, but it is an almost continuous 
one of the same severity and stops immediately when the 
infant is fed. On the contrary the cry of the colicky child 
is not appeased or checked by food. The infant may, and 
often will, take food or drink when suffering, but will 
often stop and cry while drinking. Additional food aggra- 
vates rather than relieves the pain of colic. 

474. A summary of the differences between colic and 
hunger would be as follows: 

In colic, loud, intermittent cries with periods of rest be- 
tween many cries; violent motions with the legs and body; 



THE FEEDING CHART 177 

relief after the expulsion of gas or stool, also from warm 
applications and rubbing externally or by giving warm 
aromatic teas, whiskey or gin internally, but no relief from 
the food which has been taken. 

Hunger is recognized by the continuous fretful crying of 
the infant, without any intermissions of rest, until fed. 
Warm drinks, applications and rubbing irritate the infant or 
only give relief for a few minutes and nothing satisfies the 
cry from hunger except food (345). 

The infant with perfect stools very seldom suffers from 
colic. 

475. No 24 — Weight. The infant averages about seven 
and one half pounds when born. The same infant, when 
properly fed, will average from twenty-two to twenty-four 
pounds when it is a year old. This leaves an average of 
sixteen pounds to be gained during the first year (244). 

An average increase in weight of healthy nursing infants: 

During first 3 months; 7 oz. weekly or 91 oz. 
tt 



second 3 


tt 





It 


"65 " 


third 3 


tt 


4 " 


tt 


"52 " 


fourth 3 


tt 


3 " 


tt 


"39 " 




247 " or 15 lb. 7 oz. 


th weight 








7 " 8 " 



An average weight at one year old 22 lb. 15 oz. 

The ability to take solid food after seven or eight months, 
accounts, frequently, for an increased growth during the 
last quarter of the first year. 

476. Hand-fed infants usually do not thrive as rapidly 
during the first six months as nursed infants, but gain more 
quickly during the last half of the year so that, when a year 

12 



178 FEEDING RULES FOR INFANTS 

old, if properly fed, they weigh as much as the nursed in- 
fant. 

477. The above figures showing increases in weight ar^ 
only obtained where the feeding has been continuously right 
from birth. Where none of the digestive glands in an in- 
fant have been injured by the use of unsuitable mother's 
milk or by unsuitable foods of any kind, it is easy to adjust 
the amount of fat, sugar, proteids and starch so as to secure 
those regular and steady increases in weight which always 
nake a child comfortable and happy; but where errors are 
committed through an unsuitable dietary and the resulting 
attacks of indigestion cause disturbed bowels, the losses in 
weight thus produced are very slowly retrieved even with 
good feeding (270). It requires only a very little error in 
the dietary to prevent the infant's growth and set it back 
for a month before it again shows steady advances in weight. 
So important is it to avoid committing these errors that 
regular weighing of the infant cannot be too firmly insisted 
upon. 

478. The regular weighing of an infant is an absolute 
necessity to show its progress and indicate the amount of 
food needed each day. The old practice of weighing an 
infant once a week or month is not enough to guard against 
mistakes. It is certainly no satisfaction to find, when 
the child is weighed at the end of the week or month, that it 
has not gained or has been losing weight most of the time 
since it was last weighed (486). 

479. In order to do good work, the mother should weigh 
the child at least twice a week. To be perfectly sure of 
the infant's progress and avoid damages resulting from un- 
suitable dietary, it is better to weigh it every day im- 
mediately before its bath. When an infant is increasing 



THE FEEDING CHART 179 

steadily in weight, the scales will show the daily changes in 
a very errative way, gaining or losing from one-half to two 
ounces daily; but in satisfactory progress, the losses will 
be less than the gains. This erratic progress in weight, 
where an infant is thriving steadily, is due to the length of 
time since last feeding, urination or stool. As this varies 
every day, it is inevitable that a good pair of scales must al- 
ways show an erratic progress either upward or downward. 
Where the scales show that the child is not gaining in weight 
or that it is losing a little, it is evident that the infant is 
either not getting enough food, or the food, if abundant in 
quantity, is unsuitable in quality (244). 

480. Where the infant is cross, restless, uneasy and does 
not gain in weight but still shows healthy well-formed stools, 
with freedom from gas, it is evident that the food is correct 
in quality but not sufficient in quantity (255). But where, 
on the other hand, the child is unhappy, restless, gassy and 
uneasy and the stools are too numerous and bad in quality 
and odor, it is equally evident that the failure in weight is 
due to the quality of the food. 

481. Regular weighing is so important that every mother 
should provide herself with a set of scales. The weight 
must be shown in half ounces or ounces and the scales act 
quickly, so that only a second or two are required to see 
the advances or losses. 

482. A good pair of scales are absolutely essential for 
success in feeding an infant, but are very seldom needed 
where the child is properly nursed by the mother; in fact, 
they are never required when the mother's milk is correct in 
quality and amount, but their use is a necessity where an 
infant is not happy and does not sleep or grow satisfactorily. 

483. The expense incurred in buying the scales should 



180 FEEDING RULES FOR INFANTS 

never be considered, as they will more than repay this many 
times over in avoiding those sicknesses sure to follow over- 
feeding or unsuitable food. 

484. Where an infant is not increasing in weight regu- 
larly, the scales point this out clearly, long before the parents 
see it. This enables them to increase or change the food 
and thus avoid errors in nutrition with the diseases result- 
ing therefrom. 

485. As the weighing of the infant is important only to 
show its progress, a scale that can be used regularly with 
little trouble and also one which occupies little space is 
necessary. It should have a platform on which a basket can 
be fastened securely. In this basket the infant can be placed 
and the revolving dial on the face of the scale will at once 
show the exact weight in half ounces or in ounces. Such a 
scale can be bought for one dollar. The cheap scales which 
are held in the hand and suspend the child from a hook 
are not reliable and should never be used. The ordinary 
grocer's scale will also do this work correctly. 

486. The regular weighing of an infant, then, is essential 
and a necessity in all conditions excepting that one where 
human milk is entirely satisfactory. 

487. No. 25 — Gas. There is always a natural amount 
of gas in the stomach and bowels of an infant. This seems 
to be part of nature's plan in order to retain a somewhat 
even-sized abdomen at all times. When food is taken into 
the stomach, there is distention of this organ in proportion 
to the size of the meal, and the result is that the first 
contraction in the process of digestion expels a sufficient 
amount of gas to make room for the food. This causes 
belching once or twice after feeding and should be considered 
natural and healthy. 



THE FEEDING CHART 181 

488. Frequently a mother is too hasty in putting her 
infant in the cradle after taking a meal and before this gas 
is expelled; consequently, it feels uncomfortable until raised 
up and the gas allowed to escape. 

489. Parents often complain of their infants having a 
great deal of gas because they hear it rumbling around inside 
of them, though it is not being thrown out. This complaint 
is not always an evidence of indigestion, as hungry infants 
will show this same noisy, gassy condition. 

490. Only that extra gas which is thrown out from the 
mouth or rectum can always be looked upon as reliable evi- 
dence of an unsuitable dietary. 

491. No. 26 — Gas, up or down. When fermentation 
of food occurs in the stomach, it produces belching of gas, 
more or less continuously from one meal to the other. This 
is usually due to the extra large size of the meal. It may 
also be due to the quality of the food, but most commonly 
results from the extra amount of food. 

492. Nature gives the digestive glands power to secrete 
a definite amount of digestive fluid after each meal. When 
the food is greater than this amount of fluid will digest 
comfortably, continued fermentation and consequent belch- 
ing always follow. 

493. The same principles regarding gassy discharges 
from the stomach apply to the bowels also. There is al- 
ways a natural amount of gas passing from the bowels of 
the healthy infant which causes neither pain nor inconven- 
ience; but, when there is a continual or frequent passage of 
gas in this way, it shows that a portion of the food is de- 
composing below the stomach at some point in the intestinal 
tract. If this gas is accompanied by very foul odors, the 
inference is that part of the animal food, such as the cream. 



182 FEEDING RULES FOR INFANTS 

or skim-milk is decomposing instead of being digested. 
In this case, the infant suffers a good deal from colic, and 
the stools are numerous and soft with an increased amount 
of mucus. Generally, they are green or mixed in color. 

494. Starch is capable of producing more gas than any 
other food and a reduction in this item usually is followed 
by a corresponding reduction in the amount of gas dis- 
charged. 

495. Where an infant is partaking of a mixed starch and 
milk food and there is not much odor to the extra gas that 
is thrown out of the bowels, the error probably lies in the 
amount or character of the starch which is consumed. 

496. No infant can be happy and grow well who is 
suffering from constant belching or rectal discharges of gas. 

497. No. 27 — Sleep. A new born infant should sleep 
twenty hours in every twenty-four. As it grows older the 
hours of sleep are gradually lessened while it is in a perfectly 
healthy condition. Where the food is not suited to the 
infant and the digestion is imperfect, the sleep is very much 
disturbed. The infant who is not gaining in weight seldom 
sleeps well. There is no feature of the infant's condition 
which shows errors so quickly as disturbed sleep. Every 
mistake in the dietary of the healthy child is immediately 
manifested by some disturbance in this feature. The infant 
either sleeps too much or too little, too long and heavily or 
is unable to sleep continuously, waking every few minutes 
and crying out in its distress. Imperfect nutrition in the 
infant is always evidenced by disturbed sleep. This is al- 
ways the first feature giving evidence of an error and always 
the last one to be removed after the errors in nutrition have 
been corrected. An infant very readily acquires the habit 
of disturbed and irregular sleep, from which it is very diffi- 



THE FEEDING CHART 183 

cult to escape. There is no feature in an infant's character 
which it is so difficult to correct. It is amazing at times to 
find how much of this disturbance an infant will endure and 
yet, apparently, thrive moderately well. Good sleep is 
generally an evidence of successful nutrition and infants 
who sleep well usually grow and make weight steadily. 

The following are the most frequent causes of disturbed 
sleep: 

1st — Unsuitable quality of food. 

2d — Too much food. 

3d— Too little food. 

4th — Gassy accumulations in stomach or bowels. 

5th — Imperfect nutrition. 

6th — Habit of waking. 

7th — Too much heat. 

498. Medical treatment is never successful in correcting 
the wakeful habits of imperfectly nourished infants. Only 
good health, an increase in weight, fresh air and sunshine 
will ultimately succeed in removing this very annoying and 
trying habit. 

499. No. 28 — Temper. An imperfectly fed infant is al- 
ways cross and troublesome. While it is an unpleasant 
thing to have a child cross and unhappy in the daytime, it is 
very much worse when this condition is extended into the 
night. This disturbed sleep and cross, restless habit of the 
infant is an indication of an error somewhere, and usually, 
it is found in the wrong or deficient diet of both nursed and 
hand-fed infants. The errors in the mother's diet, labor, 
mental condition and health are generally transmitted to the 
infant through the milk supply. All errors which disturb 
the infant in sleeping hours also have the same effect during 
waking hours, and cause crossness and irritability. These 



184 FEEDING RULES FOR INFANTS 

errors may be due to the quantity of the food as well as the 
quality. 

500. It is a common thing to hear a mother speak of her 
baby as being a very cross one; or, in fact, claiming that all 
her children are cross; not realizing the fact that this cross- 
ness is a matter entirely of her own making (352). The 
natural condition of every infant is to be happy and good 
natured; but, to secure this, the general care and feeding 
of it should be uniform and correct whether nursed or hand- 
fed. The infantile constitution is very much opposed to 
irregularities and very sensitive to errors, and the only 
way it has of showing these errors is by that crossness 
which is always natural under unsuitable and unhealthy 
conditions. There is no such condition as that of a natur- 
ally cross yet perfectly healthy and properly fed infant. 

501. No. 29 — Hungry before meals. This is a very 
important feature to be observed in hand-feeding. With- 
out a proper recognition of what this means and a strict ob- 
servance of its necessities, there can be no success in feeding 
an infant. Where the food is entirely suited to the infant's 
digestion, the child will remain happy and comfortable only 
just so long as the stomach is properly occupied in digest- 
ing food. As soon as the meal is completely disposed of, it 
again becomes hungry, restless, uneasy and cries for more 
food. When the meal is large enough to satisfy the demands 
of the stomach to within five or ten minutes of the next feed- 
ing hour, the child will be happy and grow regularly. Where 
it becomes hungry, restless, uneasy and cries out for food 
but is compelled to wait more than five or ten minutes for 
the next meal, it will fail to make weight just in proportion 
as that time is longer than the regular five minutes necessary 
for success. 



THE FEEDING CHART 185 

502. An infant who becomes hungry and habitually cries 
for its food fifteen to twenty minutes before the next meal, 
even when fed most suitably and perfectly, cannot make 
weight (654). 

503. An infant who is persistently hungry and cries 
twenty to thirty minutes before the next meal is losing 
weight rapidly (654). 

504. An infant who does not become restless and call for 
its food at least five or ten minutes before the next meal is 
usually overfed, and persistence in feeding amounts which 
are not completely digested before the next meal is given, 
as is shown by the child's failure to demand another meal, 
is very likely soon to cause indigestion, producing de- 
composition or fermentation of a portion of these too large 
meals. 

505. There is only one true way of gauging the amount 
of food which should be given at each meal, and that is to 
have it that size which will make the child hungry and call 
for food five minutes before the next feeding. This is very 
easily regulated by the mother, as she very soon sees that 
one or two spoonfuls more or less in the meal usually varies 
the time at which the infant cries for the next feeding. 
When the meal is a little too small and the child becomes 
restless twenty minutes or one-half hour before the next 
meal it is always better to feed at once rather than hold to a 
fixed rule for time of feeding. An intelligent mother always 
exercises that elasticity of ten or fifteen minutes before or 
after the usual hour of feeding when she sees this is necessary 
to keep the child comfortable and happy. This privilege of 
feeding when an infant is hungry can only apply to those 
who digest perfectly and have perfect stools, as they only cry 
and worry when hungry. The imperfectly fed infant is 



186 FEEDING RULES FOR INFANTS 

cross all the time and no one can know when it is hungry. 
It must be fed at fixed hours. 

506. No. 30 — Temperature. In the healthy and perfectly 
fed infant, the temperature is not a subject that often re- 
quires consideration. Where this varies enough to cause 
restlessness, the extra heat of the infant will give warning 
of sickness. As the child in a feverish condition can never 
digest as much food as when healthy, it is always necessary 
that the meals should be reduced in size as soon as there is 
any .fever. This is an absolute necessity in order to avoid 
complicating the approaching sickness by adding a disturb- 
ance in the digestive organs also. 

507. As overfeeding and unsuitable food are common, 
and Ihe most frequent causes of fever in infants, it becomes 
necessary to promptly reduce the food always and thus avoid 
increasing the fever, especially when errors in the dietary 
have been the cause thereof. 

508. .The amount of reduction should always be liberal 
enough to give relief by lightening the work of the digestive 
glands. This will demand a reduction of at least one-quar- 
ter, one-half or even three-quarters in the size of each meal. 
Just in proportion to the height of the fever is the restless- 
ness of the child and the necessity of reducing the food. 
When this reduction is made, there should be a correspond- 
ing or greater addition in the amount of water to replace 
that food which has been removed. These temporary 
changes or reductions should be promptly made by the 
mother, not waiting for advice from the physician. Where 
fever is very h ; gh and the child nervous or the bowels dis- 
turbed, all food should be stopped for a few days or until 
the fever subsides. It should be a standing rule to cease 
feeding entirely when there is doubt about the severity of 



THE FEEDING CHART 187 

the attack. Food should never be given during a feverish 
condition in the beginning of any sickness (261). 

509. It is an impossibility for any mother to nurse her 
sick infant properly when she does not know the variations 
in temperature which are produced by sickness. 

510. The habit followed by some mothers of continually 
testing a healthy child's temperature with a thermometer, 
as a means of knowing whether it is sick or not, is not pro- 
ductive of good results. Parents, working in this way, 
concentrate their whole thoughts upon a child's temperature, 
as if this was the sole indication of its health or sickness. 
This is an error and should not be followed. The instinct 
of the mother or nurse, handling the child all the time, 
enables her to judge of its condition from every point of 
view, and thus she recognizes the sickness from disturbances 
in sleep, loss of appetite, thirst, restlessness, crossness, loose 
bowels, vomiting, cough and every other unnatural feature 
as well as fever also. 

511. During sickness, the thermometer is an absolute 
necessity to guide the mother in her treatment of the feverish 
child. Without it, there is no possibility of knowing at all 
hours how much bathing, cold dressing, food, drink or 
medicine should be used or given. With the thermometer* 
the directions of the physician can be clearly and intelli- 
gently .carried out. In selecting one, a half or one-minute 
thermometer should be preferred. 

512. The temperature of an infant should always be 
taken in the rectum. It can not always be taken correctly 
at any other point in the body and very serious errors fre- 
quently follow efforts to take the temperature in the groin,, 
under the arm or in the mouth. The temperature of the 
rectum gives the only true record of the child's fever. 



188 FEEDING RULES FOR INFANTS 

513. No. 31 — Urine. This is an item which varies con- 
tinuously with the characters of the food. It always be- 
comes dark colored and smoky when beef juices are fed. It 
also varies according to the amount of food and the perfect- 
ness of digestion. The principle feature noticeable is the 
dark color and very strong odor which the urine emits when 
an infant is overfed. This is due to the absorption of im- 
perfectly digested or poisonous products of food which are 
eliminated through the kidneys and thus cause this strong 
odor, just as fermenting or decomposing food causes foul, 
gassy stools. This condition should always be an indication 
to reduce or change some part of the dietary. Urine of this 
character is very likely to scald the infant and cause a fre- 
quent desire to urinate and also make the infant nervous and 
restless in the daytime, with disturbed sleep at night. 

514. No. 32 — Genitals. Soreness and scalding of the 
genitals are usually the result of unsuitable dietary or wet 
diapers. The mother should be careful to avoid this irrita- 
tion by frequently changing the diapers, avoiding all wash- 
ing, and always oil the irritated parts freely. Infants, 
suffering in this way, are not necessarily badly fed nor are 
they always suffering from want of care; but there is more 
of some food given them than there is ability to digest per- 
fectly. Most commonly, this can be traced to the amount 
of sugar in the dietary; but, in many, it is due to the 
excessive amount of food. It is very difficult to prevent 
some fleshy infants from scalding when moisture from per- 
spiration or any other cause is allowed to continue on the 
surface. These causes of irritation must not be confused 
with errors of diet. 

515. No. 33 — Abdomen. Some people are foolish 
enough to boast of the wonderful strength and health of 



THE FEEDING CHART 189 

their infants simply because the) 7 have large abdomens. 
Perhaps there could be no greater error made than to esti- 
mate strength and endurance by the size and proportions of 
the abdomen. This idea may be correct as long as the 
largeness thereof is not greater than the symmetry of the 
infant allows; but, when the abdomen of an infant projects 
beyond the ribs, either in front or on either side, the infant 
should be considered a weaker or more delicate one and to 
have suffered from unsuitable dietary just in proportion as 
the abdomen has been distended beyond these outlines. The 
distention, in these cases, is always due to foul gases thrown 
out by decomposing food in the intestinal tract. When 
this is continued for months, the muscular coats of the 
intestines have lost their strength and stretch very easily, 
thus causing this ungainly shape. Infants who have suffered 
in this way many months require the most careful feeding 
to remove this deformity and repair the damages caused by 
improper feeding. The physician should always decide the 
cause of this deformity, for, in some infants, it is due to 
diseased organs or parts in the abdomen. 

516. No. 34 — Skin. In the healthy, well-nourished 
infant, the skin is usually smooth and free from eruptions; 
but where the diet has been persistently wrong, it is a very 
common thing to find children showing eczematous eruptions 
on the skin, particularly upon the cheeks and forehead. In 
many cases, these eruptions will appear upon other parts of 
the body also, especially upon the back of infants who sleep 
in very warm beds, and around the hips where thick diapers 
are worn. Some children inherit a disposition to skin erup- 
tions, but the great majority of these diseases in infants 
under a year old are due to errors in the dietary. As long 
as these children continue to be overfed and have foul, un- 



190 FEEDING RULES FOR INFANTS 

healthy stools, there is no possibility of having these erup- 
tions removed. Generally, good diet will remove them in a 
few weeks, and as they grow older and use a more diversi- 
fied food, these skin eruptions gradually pass away. If 
they do not quickly subside, the physician should be con- 
sulted, as some of them are not traceable to the diet alone. 

517. No. 35 — The Head. The opening, or fontanelle, 
in the head of the- young infant remains open to some 
extent until the child is fifteen to eighteen months old. In 
infants improperly fed, it will remain open very much longer. 
Such an infant is also slow in teething. Slow development 
of bone is generally considered an evidence of deficient min- 
eral constituents in the dietary and always demands a change 
of food. Infants who are kept entirely on a milk diet, either 
human or cows, longer than six or eight months, are very 
likely to show this deficiency; but, just in proportion as 
starchy food is added to the milk and properly digested, so 
will the growth of bone be increased. 

518. Many mothers make the serious mistake of thinking 
that no food can be as good for an infant as a continued milk 
dietary. They may, in this way, grow babies large and 
fat, but very pale and deficient in energy. It is generally 
found, in these infants, that the deficency in the growth of 
bone also means softness of bone, and this allows the head 
to become enlarged and ill-shaped. These infants show 
very little resistance to sickness and the mortality among 
them is very high when attacked by th'e ordinary ailments 
of infancy. They are very liable to develop convulsions and 
head affections as a result of slight sickness. In their ordi- 
nary health they are prone to deformities such as crooked 
spines, bow-legs or knock-knees. 

519. No. 36 — Veins. The appearance of large blue 



THE FEEDING CHART 191 

veins upon the head and temples of a pale child shows an 
undue determination of blood to the brain. These infants 
generally pass into a very nervous condition with a strong 
liability to convulsions or inflammation of the brain from 
slight cause. The bony structures are generally soft and 
deficient in growth and the inordinate circulation of the 
blood in the head, by pressure on the bones, thus enlarges 
the head and frequently changes the shape also. This condi- 
tion is often the result of poor nutrition, and these infants 
are always so near the inflammatory point that it requires 
very little stimulation, through some dietetic error, to pro- 
duce a genuine head affection. Children in some families 
inherit the disposition to grow this way. Unsuitable dietary 
and continual living in warm rooms tend to produce this 
result in others. This disposition in an infant requires the 
utmost care in the diet, the best hygienic surroundings and 
long-continued watchfulness to avoid bad results. They 
should live in the open outside air as much as possible. 

520. No. 37 — Flesh. There is, perhaps, no better test 
of the perfect nutrition of an infant than the hard, firm con- 
dition of the flesh. Just in proportion as the nutrition is 
poor and deficient, so will the flesh be soft and flabby. The 
flesh of the well-fed infant becomes hard, firm and elastic, 
and when pinched up between finger and thumb, gives a 
resistance always guaranteeing success. The skin of these 
infants is always mottled and pink, an unmistakable evi- 
dence of the best infantile nutrition. 

521. No. 38 — Bones. Under item No. 35, we have 
spoken of the effect upon the teeth and bones of the head 
produced by an imperfect dietary. As children grow older, 
the long bones will also give evidences of unsuitable food 
This is seen in rickety children when the muscles become 



192 FEEDING RULES FOR INFANTS 

stronger and they make some effort to use their limbs. 
Curvature of these long bones results from a diet which 
gives an insufficient firmness and strength to the bone. The 
result is that, when these infants commence to walk, they are 
likely to become bow-legged or knock-kneed. The ribs also 
become flattened on the sides, pressing the breast-bone out- 
ward or forward, giving the infant that chicken-breast ap- 
pearance, characteristic of a rickety child. Other bone 
deformities also appear (15), but those mentioned above are 
the most conspicuous. 

DIRECTIONS FOR USING THE FEEDING CHART 

Amounts of food 

522. 2 — Cream (fat). First week: Two to eight tea- 
spoonfuls of lightest cream daily. Next three weeks: Two 
to four ounces daily. One to nine months: Two to six 
ounces daily if well digested (240). 

523. 3 — Human milk. It is required only during the 
first few weeks in healthy, well-developed children, but 
longer for infants who have been damaged by unsuitable 
nursing or substitute feeding. Five to eight ounces daily, 
added to the other food, are generally enough to increase 
the digestion and give marked improvement in the infant 
(198). 

524. 4 — Skim-milk (proteids). First week: None. 
Next three weeks: Very little, or one-half to one ounce 
daily. One to twelve months: Two to twenty-five ounces 
daily (241). 

525. 5 — Whey (liquid proteids). It is used only when 
enough skim-milk can not be digested, Large amounts 
thereof may require reduction of the sugar. It is about 



DIRECTIONS FOR USING FEEDING CHART 193 

one-third the strength of skim-milk and may be used propor- 
tionately (395). 

526. 6 — Lime-water. First week: One-half to one 
ounce daily. Next three weeks: One to two ounces daily. 
After the first month: One to two ounces daily and more in 
hot weather. Add to the meals just before feeding (401). 

527. 7 — Water (boiled or filtered). First week: Eight 
to twelve ounces daily. Next three weeks: Twelve to 
seventeen ounces daily. One to two months: Eighteen to 
twenty-one ounces., daily. After two months: Gradually 
reduced as milk increases. 

Shortage in amount of water gives dissatisfaction after 
feeding. Overfeeding causes spitting or vomiting of water 
and continual urinating. 

528. 8 — Milk-sugar. First week: One ounce to sixteen 
ounces of food mixture. Next three weeks: One ounce to 
fourteen ounces of food mixture. After first month: One 
ounce to eighteen or twenty ounces of food mixture. It 
must always be reduced as additions of starch show irrita- 
tion of the rectum (306). 

Cane-sugar. When this is used instead of milk-sugar, 
only half the above amounts can be given (408). Both sugars 
may be combined in some cases with great benefit (236). 

529. 9 — Starch. ' Only small amounts are added before 
third month (303). That kind should always be used which 
is most easily digested whether it is malted, baked or boiled. 
The amounts are shown in the feeding schedule (573-579). 

530. 10 — Unused food. There should always be made 
at least one meal more than is fed each day. This provides 
for accidents to bottles. The amount of unused food should 
be recorded regularly to detect errors in the size and number 
of meals (416). 

13 



194 FEEDING RULES FOR INFANTS 

531. 11 — Beef tea, beef juice and albumen. These 
foods are allowable only when milk can not be digested. 
Beef tea and albumen are seldom used for infants under six 
or eight months old and are very poor substitutes for the 
milk diet. In older children, they are valuable when used 
with a starchy diet (417). 

532. 12 — Feed, how often. Every one to three hours 
within five minutes after the child shows hunger (419-425), 
if the stools are formed. 

533. 13 — Day meals. These should be given regularly 
whether awake or asleep. Two alternating sizes should 
always be used, varying in size from one-half to three- 
fourths of an ounce to show which is digested most comfort- 
ably (429). The number fed daily must not vary (454) 
unless when reduced as the infant becomes older. Food can 
be increased by strengthening it or increasing the size of 
the meals. 

534. 14 — Night meals. These should be one-half to one 
ounce larger than the largest day meal and only fed when 
the infant awakens. They always become fewer with 
increasing age. In well-fed infants, four to six months old, 
there may be none from 7 or 8 P. M. till 6 A. M. The 
largest meals are always needed after and before the long 
night sleeps. Young infants (under six months) have the 
most perfect digestion during the night (437). 

535. 15 — Whole day's food. This records the amount 
fed each twenty-four hours. Well-fed infants seldom show 
a variation of more than one-half ounce from day to day. 
Great variations always mean failure except when made in 
sickness or to correct errors. This item must always be 
recorded (443). 

536. 16 — Spits. This refers to the one-fourth or one- 



DIRECTIONS FOR USING FEEDING CHART 195 

half teaspoonful often raised by gas or hiccough. It indi- 
cates a full stomach and warns against increasing the size 
of meals (447). 

537. Vomits. This shows too large meals or too much 
fat or sugar in the meals. When only water appears, the 
food is too dilute (450). 

538. • 17 — Number of meals daily. These should always 
be uniform. Irregularity in number prevents success (454) 
except when hunger or poor digestion demands a variable 
number of meals at times (228-230). 

539. 18 — Medicine. This is only a record for future 
use or guidance. Usually, only digestive preparations are 
recorded (151). 

540. 19 — Stools, their number. One or two daily are 
evidence of success. Greater numbers generally show 
imperfect digestion of food except during the first month 
(459). 

541. 20 — Color. An even color shows perfect, and 
mixed shows faulty digestion; color also shows the kinds 
of food used. Milk stools should be always yellow. Starch 
gives a dark color (460-463). 

542. 21 — Odor. Natural shows perfect digestion. Foul 
or strong odors prove fermentation or decomposition (465). 

543. 22 — Kind. Splashy is due to fermentation, mostly 
of sugar or starch (466). Soft shows imperfect digestion 
(467). Formed shows perfect digestion (468). 

544. .23 — Colic. Usually shows unsuitable feeding either 
in quantity or quality (470). 

545. 24 — Weight. Should be recorded daily for perfect 
work. Increases of more than one ounce each day in hand- 
fed infants soon result in indigestion and diarrhea (479). 

546. 25 — Gas. Extra gas is proof of overfeeding either 



196 FEEDING RULES FOR INFANTS 

in the size of the meals or in some of the foods contained 
therein (491). 

547. 26 — Gas (up or down). Coming up shows indiges- 
tion in the stomach, and going down shows it in the bowels 
(491). 

548. 27 — Sleep. A properly fed infant sleeps well. A 
hungry or overfed one always sleeps poorly (497). 

549. 28 — Temper. This is disturbed in the same way 
as the sleep (499). 

550. 29 — Hungry before meals. Should be only five 
minutes. Fifteen to twenty minutes means no growth. 
Thirty to forty minutes means loss of weight (654). 

551. 30 — Temperature. Fever demands a reduction of 
the food (506). 

552. 31 — Urine. Changes in this often indicate ap- 
proaching sickness or show errors in the food (513). 

553. The remaining seven items are intended mostly for 
the physician's use and do not require daily attention. All 
the previous items are a daily guide and educator for the 
mother till she becomes expert in detecting errors. After 
she becomes familiar with this work, she can use a very 
simple chart devised by one of my patients (555). It is a 
record of the food, weight and number of stools, enabling 
any mother, well educated in this work, to see quickly what 
progress is made from day to day and also the exact diet 
used. 

554. Where errors are made and sickness is the result, 
both charts show where correct work was done, and a return 
to the diet at that point generally corrects the disturbance. 



DIRECTIONS FOR USING FEEDING CHART 



197 



555. . 


THE 


RECORD CHART 






April 


4 


5 


6 


7 


8 


9 






Cream 


















Skim-milk 


11 oz. 


11 oz. 


11 oz. 


11 oz. 


11 oz. 


11 oz. 


Ywter 


7 oz. 


7 oz. 


7 oz. 


7 oz. 


7 oz. 


7 oz 






Granulated sugar, 
teaspoons 


2 


2 


2 


2 


2 


2 


Imperial granum, 
teaspoons 


4 


4 


4 


4 


4 


4 


Durkie's rice flour, 
teaspoons 


2 


2^4 


2y 2 


2/2 


2/ 2 


2/ 2 


Malt extract, teas. 


4 


4 


4 


2 


2 


2 


Stools 


2 


1 


1 


2 


1 


1 






Weight 


12-14*4 


13-0^ 


13-2 


13—3 


13-4/ 2 


13—7 






Unused food 





















The above chart is an exact copy from daily work of a 
very intelligent and experienced mother who was unable to 
nurse this infant or an older brother successfully. It will be 
noted that skim-milk, a baked starch (Imperial Granum) 
and a boiled rice flour were used together. The Malt Ex- 
tract was added to overcome the constipation. Mellin's 
Food in one or two teaspoonf uls, daily amounts, will often do 
this also. Such increases in weight as are shown above 
always guarantee the future success of the infant mentally 
and physically. 

556. This chart illustrates what features may or should 
be retained by a mother who has filled the educating chart 
for several weeks until she has become familiar with all the 
features necessary in feeding an infant successfully. The 
main object of this record chart is to keep a full but short 
account each day of the exact amount of all foods given, 
the number of stools and the changes in weight. 



198 FEEDING RULES FOR INFANTS 

557. If an error occurs at any time and sickness follows, 
a reference to this chart shows where the feeding was cor- 
rectly done and where the error commenced. This enables 
the nurse or mother to return to the last formula which 
gives correct results. In this way, errors are corrected at 
once and sickness soon relieved. No woman should attempt 
to feed an infant without keeping an exact record daily of 
all foods given and the effects thereof. 



CHAPTER VIII 

FOOD SCHEDULES 
MILK IN THE SCHEDULES 

558. In preparing milk for these schedules, certified 
milk from Towars Wayne County Creamery was used. 
It was mostly Jersey and Holstein mixed, cooled as soon as 
drawn from the cows, then bottled and kept surrounded 
with ice continuously until delivered to the customers. It 
varied in age from sixteen to twenty-four hours, and in 
winter, may have been thirty-six hours old before being 
used. The cream measured about six ounces on the top of 
each quart and was carefully removed from the milk by 
pouring it off, thus leaving the cream and skim-milk sepa- 
rate and ready for use; newer milk is desirable but difficult 
to obtain in cities. 

559. When milk cannot be obtained in this way, it 
should be put into a fruit jar or milk bottle as soon as 
drawn and packed in ice until the cream separates. This 
occurs more rapidly with milk from some cows than from 
others, and also occurs in proportion to the amount of ice 
with which the milk is surrounded. The colder the milk 
is kept, the more quickly will the cream and milk separate. 
Usually, with an abundance of ice, cream will separate in 
two or three hours. When less ice is used, the time will 
extend to four or five hours (119). When milk stands only 
in a cold room or cellar, it will require from twelve to twen- 
ty-four hours or more, according to the temperature of the 
place in which it stands. Animal heat should always be 

199 



200 FEEDING RULES FOR INFANTS 

driven out of milk as quickly as possible after it is drawn, 
by the use of cold water when ice cannot be obtained. 
Milk should always be bottled to exclude air and allow the 
surrounding cold to reduce the temperature as rapidly as 
possible (122). 

560. As milk is usually laxative in proportion to the 
amount of cream which it contains, a mother can, in a few 
days, ascertain the number of hours which she must leave 
it standing in cold surroundings before preparing the baby's 
food. This will depend upon her facilities for cooling it. 
In proportion as she removes the cream, so will the remain- 
ing skim-milk become more constipating. If she finds that 
the skim-milk left, after removing all the cream which rises 
in two hours, is still loosening to the bowels of the infant, 
she can allow the milk to stand an additional hour or two in 
order to remove enough cream so that the remaining milk, 
when diluted with water and properly sweetened, gives the 
requisite one or two soft formed stools necessary each day 
for the infant's proper growth and development (390). 
When any difficulty is experienced in making the infant 
happy or securing formed, stools, the food should always be 
thoroughly pasteurized after it is prepared for use (145). 

561. Mothers in different localities, with different facil- 
ities and different breeds of cows, can very quickly prepare 
fresh food for infants who can digest one ounce of cream 
with every four to five ounces of milk, by using new milk 
and sugar-water. When any of the schedules Nos. 1 to 7 are 
used, they can adjust the skim-milk to the necessities of 
their infants by removing a greater or lesser amount of 
cream from it, as in 560. This plan will supply a fresh milk 
and give the same or better results than those obtained by 



FOOD SCHEDULES 201 

people in cities and towns who receive an older bottle-milk 
with the cream entirely separated, and then require to bring 
the cream and, skim-milk together again in the proportions 
needed for successful feeding. 

562. Top-milk is the name given to eight ounces or more 
of cream and milk taken from the top of the bottle after 
the cream has entirely risen. This usually requires eight 
ounces for young infants from two to three months old, but 
is enlarged to twelve and sixteen ounces as they grow older. 
This top-milk is suited to some infants when properly diluted 
with sugar-water. An increased amount of milk is always 
taken with the cream when greasy, fatty stools show fat 
decomposition instead of perfect digestion. 

563. The simplest method and the one by which the few- 
est mistakes are made and which meets all types of diges- 
tive powers is to separate the cream and milk entirely and 
then bring them together in a proportion suitable to the 
digestive power of any infant (118-120). This is the plan 
which the author has found most satisfactory and success- 
ful and the one followed in all the following schedules 
(573-579). 

564. In warm weather, when ice is not obtainable, fresh 
milk should be kept in a well, cellar or any cold place until 
the cream has been removed and the milk prepared for feed- 
ing (560). This method will give a fresh food free from 
souring, and if the food is bottled, pasteurized at once and 
kept cold, it will remain sweet until fed (122). 

565. All milk should be pasteurized during warm 
weather after the cream is removed. This should be done 
to kill the souring bacteria which accumulate so rapidly in 
summer and thus spoil all milk foods (145). 



202 FEEDING RULES FOR INFANTS 

566. The amount of cream on a quart of milk varies 
from four ounces on the poorest grades to six and one-half 
on the richest Jersey milk. This allows one ounce of cream 
to every seven of skim-milk in poorer grades and one ounce 
to every four and one-half in the richest grades. 

567. As it is always necessary to feed milk as new and 
fresh as possible, it is best, when new milk can be obtained, 
to try feeding it diluted and sweetened according to the 
feeding schedules without waiting to separate the cream. 
This is especially necessary when the infant's digestive 
power is weak, and also in country places when an abund- 
ance of ice cannot be obtained to preserve the milk (204). 

568. This plan will seldom be successful in infants 
during their first month, when they usually thrive best on 
a diluted cream only as in 610 ; but, after that age, it is 
well to try feeding with milk diluted two, three or four 
times and sweetened by adding one ounce of milk-sugar to 
every eighteen or twenty ounces of milk and water com- 
bined, or one ounce of granulated sugar to every thirty-five 
or forty ounces of the food mixture. 

569. If the proportion of cream is too high, the stools 
will be fatty, greasy, rancid and foul odored. If there is 
not enough cream to suit the infant, the stools will be dry 
and constipated. The latter condition requires more cream 
(243). 

570. When making a trial in this way, great care must 
be taken to give only small meals and always repeat them 
when the infant shows hunger, whether that be in one hour 
or two. This applies only to infants with soft but healthy 
stools. For success, the hungry infant with healthy stools 
must never be kept waiting more than five or ten minutes 
for its food (501). 



FOOD SCHEDULES 203 

571. Experience shows that the majority of infants 
cannot digest the natural proportion of cream in rich Jer- 
sey milk, and some require a large amount of it removed 
before they can be happy in daytime and rest well at night 
(115). 

51 2. This great diversity in the feeding power of 
healthy infants is due mainly to the imperfectly developed 
condition of their digestive glands. In infants who have 
been wrongly fed, these glands are frequently injured by 
the fermenting or decomposing food resulting from too 
large meals or unsuitable proportions of foods in the meals. 
Infants of this class must always be fed very small meals 
frequently repeated (230). 

The following schedules were selected from over 15,000 
daily records of the amounts of foods given to infants each 
day. Their dietetic effects and advances in weight are 
shown in each case. All of these records were filled by 
the mothers or nurses and show great attention to details. 
They fairly represent the different types from small and 
weak but healthy infants to the large, vigorous ones, and 
illustrate very well what intelligent and industrious mothers 
can do with all sized healthy infants when they understand 
how to change or increase foods daily, according to the way 

they are digested. Only one of these mothers had any expe- 
rience in doing this work before. By filling the charts, they 
quickly saw what were evidences of imperfect digestion and 

commenced at once learning to correct them. In a few 
weeks, they could generally tell clearly from the stools 
what advances and changes in foods were demanded to 
secure present and future success. 

As all of these charts were filled by the mothers, they 



204 



FEEDING RULES FOR INFANTS 



show all the changes in diet which they thought necessary. 
Some of these were mistakes, but were always corrected 
when false stools showed the errors. In no case was more 
than a small mistake made and each one was a lesson to 
the mother and strengthened her for future work. Very 
little assistance was needed by any of them and some did 
the whole work alone after the first few interviews. Edu- 
cation of this kind is what benefits posterity, as it spreads 
the true principles of human nutrition among the human 
family. 

Perhaps the most important facts which mothers have 
proven by the filling of these many thousand daily records 
of foods and their effects, are the proportions of cream, skim- 
milk, sugar and starch which are necessary to nourish each 
pound of an infant daily at different ages. While this must 
necessarily vary somewhat, the errors made by the mothers 
and shown in these schedules, together with the correc- 
tions, demonstrate clearly what amounts can be used with 
safety and success, and also the amounts which always 
prove to be a sure cause of indigestion with resulting 
diarrhea, sickness and loss of weight. 



573. 



SCHEDULE No. 1 



Age, 
days. 






Skim- 


Boiling 


Iyime- 


Starch- 


Milk- 


Cane- 


Total 


Weight. 




milk, 


Water 


water, 


water, 


sugar, 


sugar, 


Amount 




oz. 


tea. 


oz. tea. 


oz. tea. 


oz. tea. 


oz. tea. 


oz. 


oz. tea. 


oz. tea. 


lbs. oz. 


16 


1 


1 


3 3 


13 2 


1 




1 




19 


5 9 


22 


1 


2 


3 3 


14 1 


1 




1 




20 


6 10 


30 


1 


3 


4 


15 3 


1 




1 




22 


6 11 


40 


1 


2 


4 3 


15 1 


1 




1/2 




22 


6 15J4 


47 


1 


3 


5 4 


17 4 


1 




1% 


2 


25 5 


7 4 


55 


1 


3 


6 4 


17 4 


1 




l 2 A 


3 


26 5 


7 13 


63 


2 


2 


7 5 


18 4 


1 1 




2 


4 


30 


8 2 


69 


1 




7 4 


18 5 


1 




2 


3 


28 3 


8 7 


78 


1 




8 


18 3 


1 




2 


3 


28 3 


8 10# 


85 


1 


1 


8 2 


18 


2 




2 


4 


29 3 


8 13 



FOOD SCHEDULES 
SCHEDULE No. 1— Continued 



205 



Age, 
days. 


Cream, 


Skim- 
milk, 


Boiling 
Water 


Lime- 
water, 


Starch- 
water, 


Milk- 
sugar, 


Cane- 
sugar, 


Total 
Amount 


Weight, 




oz. 


tea. 


oz. 


tea. 


oz. 


tea. 


oz. 


tea. 


oz. tea. 


oz. 


oz. 


tea. 


oz. 


tea. 


lbs. oz. 


92 


1 


3 


8 


5 


17 


1 


2 


3 




2 





4 


30 




8 15?4 


98 


1 


4 


10 


1 


18 


4 


2 


3 




2 





4 


33 




9 9 


108 


1 


5 


11 




19 


2 


2 


5 




234 





4 


35 




10 2 


115 


2 




10 


4 


19 


4 


2 


3 




2'4 





4 


34 


5 


10 sa 


123 


2 




11 


4 


20 


5 


2 


5 




234 





5 


37 


2 


10 11^ 


131 


2 


1 


12 


2 


21 


1 


2 


5 


Made 


3 


1 




38 


3 


11 334 


138 


2 


2 


13 


3 


22 


1 


3 




of rice 


3 


1 




41 




11 12/ 2 


145 


2 


3 


14 


2 


23 




3 




flakes 


3 


1 




42 


5 


12 334 


153 


2 


2 


14 




24 


4 


3 




2 


SV* 





5 


44 




12 11 


161 


2 


2 


14 


2 


24 


2 


2 


4 


5 


sv* 





5 


44 




13 5)4 


168 


2 


2 


14 


1 


24 


3 


2 


4 




W 





5 


44 


3 


14 


176 


2 


2 


14 


3 


24 




2 


4 


1 


3 





5 


44 


3 


14 iy 2 


183 


2 


2 


14 


5 


24 


3 


2 


4 


1 


3 





5 


45 


2 


15 


190 


2 


1 


13 




20 


5 


2 


2 


1 


2 2 4 





4 


39 


2 


15 4 


199 


2 


2 


13 


5 


21 


4 


2 


4 


1 


3 





4 


41 


3 


15 


205 


1 


4 


13 


5 


22 


2 


2 


4 


1 


1 





4 


41 


3 


15 V/ 2 


210 


1 


4 


10 


5 


23 


3 


2 


2 


1 


1 





2 


39 


3 


15 10 



Average amount of food given daily for each pound of 
the baby's weight. 



Age 


16 
days 


I/2 
months 


2/ 2 
months 


3/2 
months 


4^ 
months 


$A 

months 


6/ 2 
months 


Weight, lbs. 


5/ 2 


m 


85/ 8 


10 


1134 


14 


roA 


Cream, tea.. 


1 


±A 


A 


VA 


A 


1 


54 


Skim-milk, 
teaspoons 


4 


434 


V/l 


6A 


•7 


6 


554 


Total 


5 


6 


6V 4 


734 


734 


7 


6 



Milk-sugar varied from one-fourteenth to one-eighteenth 
of the foods and water combined. Cane-sugar was added 
as it was well digested, improved the weight and also gave 
a pretty pink color. 

The slight irregularities in the increases of cream and 
skim-milk were due to overfeeding of them. This caused 
fermenting gas in the bowels with foul odors and softness 
of the stools. This must show at times when crowding any 
food in excess of the digestive power of the fluids secreted 
at each meal. Sugar and milk were replaced by condensed 



206 FEEDING RULES FOR INFANTS 

milk preparatory to taking the long journey in the cars 
when moving to California. 

During the last month, while changing food, the gain 
in weight was twenty-one ounces. It is always necessary 
to feed lightly when changing food in order to avoid add- 
ing more than the digestive power of the fluids secreted to 
convert it into healthy aliment. 

In any infant whose progress for six months has been 
like that in schedules 1 or 2, the same relative increases in 
cream and skim-milk after that age can usually be main- 
tained. With the substitution of suitable starch for the sugar 
and decided increases of starches after nine or ten months, 
partly bread and crackers from the hand, there can be no 
doubt of successful growth and development. 

The milk fed was mostly Jersey and carried a large 
amount of cream which did not always rise completely to 
the surface of the milk even when perfectly iced all the 
time. It was predigested a large part of the first three 
months for both of these infants in schedules 1 and 2. 

FACTS TO BE NOTED 

The reduction in cream at two and one-half months was 
due to frequent three or four greasy stools each day. 

The combination of cane and milk-sugar gave better 
results than one sugar alone. This boy and his twin sister, 
whose progress is shown in schedule No. 2, w r ere striking 
examples of this. Their pink cheeks, hard flesh, bright 
sparkling eyes and red elastic skin showed the good results 
of a perfectly digested diet carrying a high proportion of 
sugar. It will be noted that they were very small infants 
when born. In addition to their small sizes, they were 
starved, for sixteen days after birth while nursing their 



FACTS TO BE NOTED 207 

mother, who was suffering from a puerperal fever and had 
very little milk, which was also a very poor quality as it 
gave colic and green mucous stools all the time. 

Sugar was reduced at five and one-half months, when 
starch was added to the dietary. 

Skim-milk increased steadily all the time. 

Water and lime-water were three times greater than the 
milk and cream at sixteen days and less than one and one- 
half times greater at six and one-half months. 

The increases of foods for the day's dietary in six 
months were : 

Cream : One to two ounces, averaging one teaspoonful 
every twenty-five days. 

Skim-milk : Three and one-half to thirteen ounces, aver- 
aging about one teaspoonful every two and one-half days. 

Water : Twelve ounces to twenty-two ounces. 

Lime-water : One to two ounces. 

Milk-sugar : One and one-fourth to three and one- 
fourth ounces, averaging one teaspoonful every fifteen 
days. 

Cane-sugar : One-third to one ounce. 

The increase in weight of the infant w r as one hundred 
and fifty-four ounces in one hundred and eighty days, or 
only three ounces less than he would have made if he had 
nursed his mother successfully from birth. 



FEEDING RULES FOR INFANTS 



574. 



SCHEDULE No. 2 



Age, 




Sk 


m- 


Boiling 


Lime- 


Starch- 


Milk- 


Cane- 


Total 


Weight, 




' 


milk, 


Water 


water, 


water, 


sugar, 


sugar, 


Amount 




oz. 


tea. 


oz. 


tea. 


oz. 


tea. 


oz. 


tea. 


oz. tea. 


oz. 


oz. tea. 


oz. 


tea. 


lbs. oz. 


16 





3 


1 


4 


8 


5 





3 




tf 




11 


3 


4 6 


24 





3 


2 




13 







3 




V?. 




16 




4 3 


32 





2 


3 




13 


5 





4 




1 




17 


5 


3 14 


38 





2 


3 




13 







4 




1 




17 




4 3/ 2 


46 





3 


3 


5 


17 


1 


1 






IK 


K 


22 


3 


4 7/ 2 


52 





2 


3 


3 


14 


1 





4 




1 


*S 


18 


4 


4 12J/2 


58 





3 


4 


4 


18 


2 


1 






VA 


/ 2 


24 


3 


5 l/ 2 


65 





3 


4 


3 


17 




1 






VA 


*/ 2 


23 




5 3 


71 





4 


5 


4 


17 


4 


1 






1% 


M 


25 




5 QA 


77 





4 


5 


2 


19 


2 


1 






1% 


V* 


26 


2 


5 9y 4 


85 





4 


6 




20 




2 






w 


y 2 


28 


4 


5 12^ 


93 





5 


7 


1 


22 




2 


3 




2 


% 


32 


3 


5 15^ 


100 


1 




7 


2 


21 


3 


2 


3 




2 


2 A 


32 


2 


6 9^4 


107 


1 




7 


3 


21 


5 


2 


3 




2 


2 A 


32 


5 


6 11 ' 


114 


1 




8 


2 


21 


4 


2 


3 




2 


2 A 


33 


3 


7 2 


121 


1 


2 


8 


3 


20 


3 


2 


3 




2 


2 A 


32 


5 


7 5 


130 


1 


2 


9 


3 


21 


3 


2 


4 




2 


2 A 


35 




7 13 


138 


1 


2 


9 


4 


20 


4 


2 


4 




2 


2 A 


34 


2 


8 4 


145 


1 


3 


11 


5 


24 


3 


3 






2 


2 A 


40 


5 


8 11# 


152 


1 


2 


10 


5 


22 


3 


2 


4 


Rice 


2 


V2 


37 


2 


9 \y 2 


160 


1 


3 


11 


5 


23 


1 


2 


5 


flakes 


2*/ 2 


V2 


39 


2 


9 8^ 


167 


1 


4 


11 


4 


22 


1 


2 


4 


1 


8*4 


*4 


38 


2 


9 15 


174 


1 


5 


12 


2 


23 


1 


2 


5 


2 


a* 


V2 


40 


3 


10 2^ 


181 


1 


5 


12 


5 


23 


2 


2 


5 


3 


i*s 


Vi 


41 


2 


10 5 


185 


1 


5 


13 




23 


1 


2 


5 


3 


l 1 /, 


X 


41 


2 


10 103/ 4 


196 


1 


4 


11 


5 


21 


3 


2 


3 


2 


ltf 


V2 


37 


5 


10 3J4 


203 


1 


5 


11 


5 


21 


4 


2 


2 


2 


IK 


V* 


38 




10 10 


209 


1 


4 


12 




21 


1 


3 


2 


4 


1M 


l A 


39 




11 



Average amount of foods given daily for each pound of 
the infant's weight : 



Age 


16 

days 


l/ 2 
months 


2/ 2 
months 


sy 2 I W2 

months months 


53/2 
months 


6>4 
months 


Weight, lbs. 


43^ 


4/ 2 


5^ 


634 


sy 4 


934 


10K 


Cream, teas. 


Va 


% 


V2 


% 


% 


1 


1 


Skim-milk, 
teaspoons 


VA 


5K 


6 


ey 2 


7 


7 


7 


Total 


3 


6 


W2 


V/e 


7 2 A 


8 ' 


8 



The milk used was mostly Jersey and the measures used 
were spoons. 



FACTS TO BE NOTED 209 

This infant was very feeble when born and its growth 
seriously retarded by nursing the sick mother during the 
first sixteen days. The hands were cold and blue up to the 
elbows and the feet and legs cold and blue up to the knees 
when first seen by the writer at sixteen days old. She was 
not expected to live and made little progress for a month. 

Her power to digest cream was weak. It loosened her 

bowels and had to be fed in very small quantities. 

As sugars caused a scalding redness around the bowels 
when starch was added to the dietary in the sixth month, 

they were reduced at once to avoid causing indigestion and 

diarrhea. 

Water was reduced to strengthen the food, to stop vom- 
iting of water and also to allow the additions of starch- 
water. 

After excluding the first month, when it was difficult to 
keep this child alive, we find the following increases in the 
daily dietary in five months : 

Cream : Three teaspoons to one ounce, and three tea- 
spoons, or one and one-fifth teaspoons monthly. 

Skim-milk : Three ounces four and one-half teaspoons 
to eleven ounces and three teaspoons, or one teaspoonful 
in about three and one-third days. 

Milk-sugar : One ounce to two and one-half ounces, 
or one and one-half ounces in five months. 

Cane-sugar: One and one-half to three teaspoons, or 
one and one-half teaspoons in five months. 

The increase in weight was ninety-three ounces in 
152 days. When we consider the small size of this baby, 
her difficulty in living during the first six weeks and the 
damage done to her while nursing her mother, this increase 
in weight is very satisfactory. It shows an average gain 

14 



210 



FEEDING RULES FOR INFANTS 



of five ounces weekly, which is large for an infant so small 
and, more than seven ounces weekly would be for an infant 
commencing life at seven and one-half pounds, the average 
weight at birth. 

The sugar and milk were reduced at the sixth month, as 
in schedule No. 2, gradually substituting condensed milk" 
to secure safety and ready diet while traveling. 

These schedules, No. 1 and 2, are not continued farther, 
as the parents moved to California when the infants were 
six and one-half months old. 

These two schedules show the different proportions of 
food needed, and the different progress made by two infants 
on the same diet, managed by a most intelligent and indus- 
trious mother under the same conditions in every way. 
Their care and attention could not have been better. 

It was impossible to make these infants happy and sleep 
well until the milk was peptonized. From the time this 
was done, they were- entirely happy and their progress 
was perfectly satisfactory. 



575. 



SCHEDULE No. 3 



Age, 

days 


Cream, 


Skim- 
milk, 


Boiling 
water, 


Lime- 
water, 


Starch, 


Milk- 
sugar, 


Human 
milk, 


Total 
Amount 


Weight, 




oz. 


tea. 


oz. 


tea. 


oz. tea. 


oz. 


tea. 


oz. tea. 


oz. 


oz. 


tea. 


oz. tea. 


lbs. oz. 


8 


1 


3 


1 


3 


18 3 


1 


3 




1/2 






23 


10 1 


15 


1 


2 


1 




17 3 


2 


4 




1 






22 3 


9 10^ 


22 


1 


1 







11 4 


3 


5 




1 


5 


5 


22 3 


9 9 


27 


1 


4 





1 


12 5 


4 






1 


7 


2 


26 


9 13 


35 


1 


5 


2 


3 


14 3 


4 






V/2 


7 


4 


30 3 


10 hYz 


43 


2 




5 




14 5 


4 


1 




1% 


8 


3 


34 3 


10 9 


48 


2 




5 




14 1 


3 


5 




I/2 


7 




32 


11 


54 


2 


3 


5 


4 


14 5 


4 


1 




1% 


5 


2 


32 3 


11 654 


62 


2 


4 


7 




15 3 


4 


2 




1% 


5 


3 


35 


11 9 


69 


2 


5 


7 


4 


15 3 


4 


4 




1% 


5 


5 


36 3 


11 15 


76 


3 


3 


13 




13 4 


3 


3 




I/2 


5 


2 


39 


12 7 


84 


3 


2 


13 




13 4 


3 


2 




I/2 


5 


1 


38 3 


12 13 


92 


4 


2 


15 


2 


15 1 


3 


5 




1% 


4 


2 


43 


13 sy 2 


98 


4 


3 


17 


5 


16 1 


3 


4 




134 


3 


2 


45 3 


13 loy 2 



FACTS TO BE NOTED 



211 









SCHEDULE No. 3— 


Continued 








Age, 

days 


Cream, 


Skim- 
milk, 


Boiling 
water, 


Lime- 
water, 


Starch, 


Milk- 
sugar, 


Human 

milk, 


Total 
Amount 


Weight, 




oz. 


tea. 


oz. tea. 


oz. tea. 


oz. 


tea. 


oz. tea. 


oz. 


oz. tea. 


oz. 


tea. 


lbs. oz. 


105 


5 




19 4 


16 2 


3 


4 


Starch, 


2 


2 


47 





14 4 


112 


5 


4 


21 3 


16 1 


3 


3 


rice and 

oat 
flakes 


2 


1 


47 


5 


15 


119 





4 


4 


3 1 





1 


K 





8 




15 5 


126 


1 


4 


12 5 


20 5 


2 


3 


1 1 


154 





39 




14 8A 


131 


2 


4 


16 4 


19 1 


2 


4 


1 5 


' 1H 





43 




15 2 


138 


2 


4 


17 4 


20 


2 


4 


2 3 


VA 





45 


3 


15 5 


148 


2 


4 


18 


19 1 


2 


4 


3 


VA 





45 


3 


16 2, 


155 


2 


2 


16 1 


17 5 


2 


2 


2 2 


VA 





41 




16 7 


163 


2 


4 


18 


19 3 


2 


4 


2 4 


va 





45 


3 


17 


168 


2 


4 


18 2 


19 


2 


4 


2 5 


va 





45 


3 


17 5 


175 


2 


4 


18 3 


18 4 


2 


4 


3 


VA 





45 


3 


17 11 


183 


2 


4 


19 


19 


2 


4 


3 


M 





46 


2 


17 13 


192 


2 


4 


19 3 


19 1 


2 


4 


3 


VA 





47 




18 6 


199 


2 


4 


19 5 


19 1 


2 


4 


3 1 


VA 





47 


3 


19 


206 


2 


4 


19 5 


19 


2 


4 


3 2 


VA 





47 


3 


19 sy 2 


213 


2 


4 


19 5 


19 2 


2 


4 


3 


VA 





47 


3 


20 


219 


2 


4 


19 5 


19 2 


2 


4 


3 


VA 





47 


3 


20 6 


224 


2 


4 


19 5 


19 2 


2 


4 


3 


VA 





47 


3 


20 13^4 


231 


2 


4 


19 5 


19 2 


2 


4 


3 


VA 





47 


3 


21 4A 


237 


2 


4 


19 5 


19 2 


2 


4 


3 


VA 





47 


3 


21 8 


242 


2 


4 


19 5 


19 2 


2 


4 


3 


VA 





47 


3 


21 12 


249 







22 4 


19 1 


2 


4 


3 


VA 





47 


3 


22 2 


255 







5 4 


4 5 





4 


5 


X 





12 




21 ny 2 


262 







22 


18 3 


2 


3 


3 


VA 





46 




21 6 


268 







22 5 


19 3 


2 


4 


3 


VA 





48 




21 15 


276 







23 


19 2 


2 


4 


3 


VA 





48 




22 4 


284 







23 


19 2 


2 


4 


3 


VA 





48 




22 14 


286 







23 4 


18 2 


2 


4 


3 2 


VA 




48 




23 


294 







23 4 


18 2 


2 


4 


3 2 


VA 




48 






301 







24 


18 


2 


4 


3 2 


VA 




48 






308 







24 


18 


2 


4 


3 2 


VA 




48 




24 12 


314 







24 


18 


2 


4 


3 2 


VA 




48 




25 



The milk used in this schedule was from Holstein cattle, 
tested with tuberculin and certified to be free from tuber- 
culosis. 

The above foods were measured with a graduate which 
is nearly one-fourth smaller than the usual spoon measure. 
This measure and the Holstein milk, which is weak in pro- 
teids, make the proportion of milk to weight show larger 
than it is in some other schedules. 



212 



FEEDING RULES FOR INFANTS 



Average amount of food given daily for each pound of 
the infant's weight: 



Age 


8 days 


1/ 
months 


2/ 
months 


3/ 2 
months 


4/ 
'months 


5/ 
months 






Weight. . . . 


lOlb.loz. 


101b.9oz. 


121b.7oz. 


141b.4oz. 


151b.5oz. 


171b.5oz. 


Cream, teaspoons. 
Skim-milk, teas. . . 
Human milk, teas. 


1 
1 



1 
3 

5 


m 

6/ 
2 2 A 


2 

8/ 
1 


1 

7 



1 




Total 


2 


9 


10% 


11/ 


8 


7/ 





Milk-sugar varied from one-sixteenth at eight days to 
one-twentieth at three and one-half months of the food 
and, water combined. It then varied to one-seventeenth of 
the food mixture when starch was added to the dietary at 
five and one-half months. 

The continuance of milk-sugar for such a long time was 
exceptional in this infant. Usually, it has to be removed 
entirely when starch is fed liberally; but, in this case, the 
starch was not fed as liberally as could have been done if 
the sugar had been stopped entirely. His mother was too 
well satisfied to change or leave out the §ugar, and as she 
had experience with feeding two other children, she wished 
to leave "well enough" alone. 

When 192 days old, the nurse was directed not to increase 
the food any more till the child ceased to gain in weight, as 
the strong odored stools indicated overfeeding. It will be 
noticed that from 192 to 242 days there was practically no 
increase of food, but there was an increase of fifty-four 
ounces in weight in those fifty days. This was too much 
at that age, and both mother and nurse were strongly 
cautioned against a too great size, a heavy slug- 
gish baby or an acute indigestion if the food was increased 



FACTS TO BE NOTED 213 

too rapidly again. This advice was observed and the result 
is a strong, active, vigorous child, perfectly developed both 
mentally and physically. 

All cream was removed at 249 days on account of the 
greasy, foul stools. This allowed the skim-milk to be 
increased and the stools became healthy at once. 

This infant is the third one in the family. The mother 
tried to nurse the first two but was compelled to wean 
them when they were but a few weeks old, as they had 
green, mucous stools continually, were very much disturbed 
and did not thrive. She nursed this infant only part of 
the second, day and even this amount of her milk distressed 
him greatly. 

He was fed every one and one-half hours in the begin- 
ning, as per schedule, but as he did not digest the food well, 
was colicky and lost weight, a few ounces of human milk 
were obtained and added to his food. The great value of 
this addition is shown after this by the steady increases in 
weight. 

The great reduction in food when 119 and 255 days old 
was necessitated by attacks of tonsilitis with high fever. If 
the food had not been reduced,, a violent attack of indiges- 
tion with dysentery would have been the result at 119 days, 
as even with the reduced diet, dysenteric stools appeared for 
one day. 

, The proportion of milk and cream at 112 days was too 
high for an infant fifteen pounds in weight and the attention 
of his nurse was drawn to the too rapid increases of these 
items. The truth of this was shown in the advances made in 
weight afterwards on a much smaller amount of cream and 
skim-milk, when a small proportion of starch-water was 
added to the dietary. 



214 



FEEDING RULES FOR INFANTS 



The figures for starch represent the amounts of the dry 
starch boiled each day. The water shows the amount of 
starch-water which this makes daily when they were boiled 
together. The additions and substitution of oat flakes for 
rice flakes in making starch-water at 148 days caused foul, 
mucous stools and had to be abandoned. Afterwards they 
were combined and boiled together in the proportion needed 
to produce soft, formed stools. 

The proportions of milk and cream to the weight of the 
child were correct after 130 days, and with judicious 
increases in the proportion of starch, they were continued till 
the infant was ten or twelve months old, at which time 
no infant can safely use more than twenty-six ounces of 
milk and two to four ounces of cream daily. The starch 
foods were always steadily increased and became largely dry 
bread crumbs, crackers, crusts and all well-cooked cereals 
after the infant was eight months old. 



576. 



SCHEDULE No. 4 



Age, 
days 


Cream, 


Skim- 
milk, 


Boiling 
water, • 


L,ime- 
water, 


Starch, 


Milk- 
sugar, 


Total 
Amount, 


Weight, 




oz. 


tea. 


oz. 


tea. 


oz. 


tea. 


oz. 


tea. 


oz. tea. 


oz. 


oz. tea. 


lb. oz. 


42 


1 




1 


4 


17 


2 


1 






1 


21 


8 


50 


2 




5 




16 




1 






1 


24 




56 


2 




5 




16 




1 






1 


24 




63 


2 




5 




16 




1 






1 


24 


8 4 


67 


2 


1 


5 


4 


18 




1 


1 




1 


27 


8 8 


74 


2 


3 


6 




20 





1 


.3 




1 


30 


8 12 


83 


3 


4 


8 




19 


4 


1 


4 




V/z 


33 


8 12 


89 


3 


4 


8 


5 


18 


5 


1 


4 




I/2 


33 


8 12 


95 


3 


5 


10 


1 


20 


2 


1 


4 




i 2 A 


36 


9 8 


101 


3 


5 


11 


3 


19 


3 


1 


4 




1% 


36 3 


9 8 


109 


3 


2 


12 


2 


19 


4 


1 


4 




1% 


37 


10 


119 


3 


2 


13 


1 


19 


5 


1 


4 




l 2 /s 


38 


10 


125 


3 


4 


15 




19 


3 


1 


5 


Rice or 
oat 


2 


40 


10 8 


131 


3 


2 


14 


4 


16 


2 


1 


4 


1% 


36 


11 


138 


3 


5 


16 


2 


17 


2 


1 


5 


flakes 


2 


39 2 


11 


145 


4 




18 


3 


19 




2 




and 

MHlin'c; 


2 


43 3 


11 4 


152 


4 




19 


1 


18 


2 


2 




1VXCJLU11 o 

Food 


2 


43 3 


11 8 


159 


3 


4 


17 


2 


16 


4 


1 


5 


2 


2 


39 5 


12 



FACTS TO BE NOTED 



215 









SCHEDULE 


No. 4- 


—Continued 






Age, 
days. 


Cream 


Skim- 
milk, 


Boiling 
water, 


Lime- 
water, 


Starch, 


Milk- 
sugar, 


Total 

Amount, 


Weight, 




oz. 


tea. 


oz. tea. 


oz. tea. 


oz. tea. 


oz. tea. 


oz. 


oz. tea. 


lb. oz. 


167 


4 




16 3 


15 


1 4 


4 


VA 


37 5 


12 


173 


4 


2 


17 1 


14 


1 4 


5 


va 


38 


12 12 


177 


4 


5 


17 2 


12 5 


1 4 


1 


i% 


37 4 


13 


184 


4 


4 


15 3 


11 4 


1 3 


5 


Ya 


34 1 


13 4 


188 


5 


1 


17 2 


13 1 


1 4 


1 




38 2 


13 8 


196 


5 


3 


18 


13 5 


1 5 


1 2 




40 3 


13 8 


200 


5 


1 


17 


13 


1 4 


1 3 




38 4 


14 


206 


5 




17 1 


12 2 


1 4 


1 3 




37 4 


14 4 


212 


5 


1 


17 2 


12 


1 4 


1 4 




37 5 


14 8 


218 


5 


1 


17 2 


12 


1 4 


1 4 




37 5. 


14 12 


224 


5 


1 


17 2 


11 5 


1 4 


1 4 




37 4 


14 12 


230 


5 


1 


17 2 


12 1 


1 4 


1 5 




38 1 


15 


236 


5 


1 


17 2 


12 1 


1 4 


1 5 




38 1 


15 4 


The 


above 


figure 


s were 


obtaii 


led fr 


v measuring- 


with a 



spoon, allowing two flat tablespoons or six flat teaspoons to 
each ounce. Spoon measure is usually one-eighth larger 
than correct graduate measure. 

This infant was fed almost entirely on a sugar dietary 
during the first six weeks. This prevented any increase in 
weight and also made him very cross and restless. His 
buttocks and genitals were very much reddened and scalded 
by the frequent fermented sugary, splashy stools when first 
seen by the writer. He was a very healthy baby and soon 
recovered from the damage caused by this unsuitable die- 
tary, but, of course, remained lighter in weight than he 
would have been if fed properly during the first six weeks, 
the time of most rapid growth. 

The following analysis shows the amounts of the differ- 
ent foods consumed daily at different ages for every pound 
of the infant's weight : 



216 



FEEDING RULES FOR INFANTS 



Age 


6 

weeks 


10_ 

weeks 


14 

weeks 


4/ 

months 


5/ 

months 


6/ 

months 


7/ 

months 


8 

months 


Weight, lbs.. 


8 


8/ 


9/ 


11 


12 


13/ 


143^ 


15^ 


Cream, teas. . 
Skim-milk, 
teaspoons. . 


/ 
1/ 


1/ 
4 


1% 


2 
9 


2 
8/ 


2/ 
8 


2 

7 


2 
6% 


Total 


2 


5/ 


10 


11 


10/ 


10/ 


9 


8% 



It will be noticed that after the addition of starch at five 
and one-half months, the skim-milk was reduced somewhat 
and remained nearly stationary afterwards and the cream 
was increased only enough to prevent some of the constipa- 
tion caused by the starch. As soon as rice caused extreme 
constipation, farther additions and changes were made of 
other starches — oatmeal or Mellin's Food when constipated 
and rice only when the stools became too soft or watery. 
It will be noticed also that the amount of starch in his bot- 
tles never reached one teaspoonful daily for each oound 
the infant weighed. 

When additions of starch caused extra gassy discharges, 
from mouth or anus, they were reduced or kept stationary, 
and additions of skim-milk were continued within the cor- 
rect general ratio of this food to the infant's weight. After 
this, starch was again added. In this way, the effect of 
each food on the stool was noted and confusion avoided. 
Continuous alternation of food in this way every six to ten 
days secured full growth and perfect development of body 
and brain. 

If this child had been properly fed and made the usual 
gtrowth of one ounce daily during the first six weeks, he 
would have weighed seventeen and one-half pounds at eight 
and one-half months — a full average for a healthy, well- 
developed child. 






FACTS TO BE NOTED 



217 



The milk in this schedule was Jersey and fed in its raw 
condition during- cold weather. When he showed any indi- 
gestion, he was given pepsin before meals during the first 
few months. After eight months, bread and crackers were 
fed also in small amounts and he grew to be a strong, 
healthy, large child. 



577 



SCHEDULE No. 5 



Age, 
days 



56 

61 

67 

72 

78 

84 

90 

96 

102 

108 

114 

120 

126 

132 

138 

146 

150 

156 

162 

169 

174 

180 

186 

192 

198 

204 



Cream, 
oz. tea. 



Skim- 
milk, 



10 

8 
13 
13 

15 
16 
16 
18 
19 
17 
17 
19 



10 2 

15 2 
17 1 



Boiling 
water, 



5 

11 
13 
17 
16 
15 
18 
18 
18 
19 
18 
16 
16 
17 
15 
16 
16 
16 
16 
16 
16 
16 
16 
16 
16 
16 



Ivime- 
water, 

oz. tea 



Starch, 
oz. tea 



Imperial 
Granum 
Mellin's 

Food 

Oat and 

rice 

water 

1 2 

2 2 
3 

3 3 
2 

2 4 

4 2 
4 4 
4 

1 5 
4 



Milk- 
sugar, 



/ 2 
1 

l 

m 
m 
i% 

1/2 

1% 

i 2 A 
Wa 

i/ 2 
1% 

Va 
VA 
VA 
1/2 
VA 

y 2 
1 

1/2 

1/2 
% 

1 



Total 
Amount, 

oz. tea. 



10 
20 
26 
28 
33 
33 
37 
39 
40 
42 
42 
39 
39 
42 
28 
37 
40 
39 
39 
21 
23 
32 
36 
37 
23 
31 



] Weight, 
lbs. oz. 



9 4 

9 8 

9 15 

10 4 

10 13 

11 2 

11 12 
12 

12 2 
12 8 
12 12 



13 14 
14 

14 6 
14 8 
14 12 
14 

13 7 

13 

13 2 

13 

13 9 

14 



The c^aily proportions of cream and skim-milk for each 
pound of weight are shown in the following analysis : 


Weight, lbs 


8/ 2 


9/ 2 


1034 


im 


12^ 


1334 


uy 2 






Cream, teaspoons... 
Skim-milk, teas 


Va 
2/ 2 


/2 

64 


34 
7/2 


1 

- 8 


VA 
94 


Va 
4/ 2 


1 

634 


Total 


234 


m 


m 


9 


ioy 2 


5J4 


734 



218 FEEDING RULES FOR INFANTS 

Milk-sugar varied from one-seventeenth to one-twentieth 
of the food and water combined. 

Water was gradually decreased as the child became older 
and demanded a stronger food. 

Where overfeeding caused foul, splashy stools and some 
fever, the food was reduced, but these reductions in food 
were replaced by warm water to satisfy the intense thirst 
caused by loose bowels. Where nausea and vomiting accom- 
pany frequent stools, all foods and drink must be reduced 
inside the vomiting point, even if this demands total absence 
of everything for a day and night. Additions after this 
must always be governed by the ability of the stomach to 
retain what is received, no matter how small this amount 
may be. 

Infants generally thrive best when the bulk of the food 
is not more than two and one-half to three ounces daily for 
each pound they weigh. 

This infant was nursed entirely until fifty-six days old 
and suffered greatly from colic due to the quality of the 
mother's milk. He had frequent green stools and much 
gas passed from the bowels. Nursing was reduced and par- 
tial substitute feeding ad.ded. After about four weeks more, 
nursing was stopped entirely. 

The occasional decreases in the different foods were due 
to over-feeding, as shown by extra gas and foul, soft 
stools, frequently green in color and either mucous or 
splashy in character. 

This schedule illustrates the reverses following these 
errors as well as the good results that follow smaller 
amounts of cream, skim-milk and sugar when perfectly 
digested and only sufficient given to make a happy child. 



FACTS TO BE NOTED 219 

No infant can be happy when underfed any more than when 
overfed. 

Overfeeding of skim-milk is shown at 111 days, as proven 
by three foul stools daily. At this time, he weighed twelve 
and one-half pounds and was fed nearly twenty-three 
ounces of cream and milk or nearly two ounces daily for 
each pound of weight. This was too high and both were 
quickly reduced until he was taking only twenty ounces 
daily. They were farther reduced to eighteen ounces at 
162 days. During these reductions, he gained steadily till 
he weighed fourteen and three-fourths pounds and was 
taking one and one-fourth ounces daily of cream and skim- 
milk for each pound of his weight. 

The general tendency in this case was to feed too much 
and the reductions in food were not great enough to avoid 
sickness. At 162 days, vomiting with foul, mucous, watery 
stools demanded a large reduction of the food and the 
weight fell from 14.12 to 13 pounds. It was necessary 
to reduce the food more than one-half before the one 
natural stool daily was obtained. This required over two 
weeks before food could be again increased and starch 
added to the dietary. As starch was increased, the sugar 
was decreased and a reduced ratio of skim-milk and cream 
was maintained. 

The parents profited by their past experience in over- 
feeding and avoided future mistakes by always stopping the 
increases of food as soon as extra gas, passed by mouth or 
anus, showed decomposition of food or the infant became 
restless in daytime and sleepless at night. By this care, he 
grew to be a large, strong boy and required no medical care 
after the sickness when six months old. 

The milk in this schedule was Jersey and measured with 



220 



FEEDING RULES FOR INFANTS 



spoons. The cream was increased when needed to soften 
the stools and overcome constipation, and lessened when 
the stools became foul and soft or the infant cross and col- 
icky or vomited the food. The weight increased steadily for 
162 days. It will be noted that for several weeks at that 
time, all foods bore too high percentages to the weight and 
were evidently greater than the quantity of digestive fluids 
secreted could convert into healthy nutriment. The usual 
decomposition of food followed, causing indigestion with 
consequent foul diarrhea and loss of weight. The record 
shows that it required thirty days of careful feeding before 
the infant again commenced to make weight. 

By decreasing sugar as starch was added, judiciously 
increasing all foods and gradually adding solids after eight 
months, this baby became a strong, vigorous one, living 
entirely upon solid foods and, milk when fifteen months old. 
The writer saw him only a few times after first arranging 
his diet. 



578. 



SCHEDULE No. 6 



Age, 


Cream, 


Skim- 
milk, 


Boil 
wal 


ing 
er, 


Iyime- 
water, 


Milk- 
sugar, 


Total 

Amount, 


Weight, 




oz. 


tea. 


oz. tea. 


oz. 


tea. 


oz. tea. 


oz. 


oz. tea. 


lbs. 


oz. 


122 


2 


2 


6 4 


20 


1 


2 2 


IV2 


31 3 


10 




128 


2 


4 


9 


22 


3 


2 4 


1% 


36 5 


10 


8 


134 


2 


5 


9 3 


25 


2 


1 5 


2 


39 3 


10 


12 


140 


3 




11 1 


27 


2 


2 


2 


43 3 


11 


4 


146 


3 




11 3 


23 




2 


2 


39 3 


11 


10 


152 


3 




10 


26 


3 


1 5 


2 


41 2 


11 


12 


158 


2 


5 


10 1 


24 


5 


1 5 


m 


39 4 


11 


15 


164 


2 


5 


10 


25 


4 


2 


2 


40 3 


12 


1 


170 


3 


2 


10 4 


22 




2 


2 


38 


12 


12 


176 


3 


2 


11 2 


21 


2 


2 


2 


38 


12 


12 


182 


4 




12 


22 


3 


2 


2 


40 3 


13 


1 


188 


2 


5 


8 


24 


4 


2 


IX 


37 3 


13 


8 



This infant had been fed various proportions of cream, 
milk, sugar and starch until he was four months old and 
the increase in weight was very slow. 



FACTS TO BE NOTED 



221 



While using this schedule, the milk was mostly Jersey 
and taken from two dealers, but showed no difference in 
results, and the infant grew steadily and was so happy that 
the mother soon tired of filling the charts showing its pro- 
gress. She lived in the country twenty miles away and 
called only once in ten days. 

It will be seen that the amount of food given daily was : 
Cream V/i to \Y\ \ Teaspoons for each pound in weight 
Skim-milk 5;4 "6 j of child. 

Milk-sugar was about one-twentieth of the whole food 
mixture. 

The apparent reductions in the amount of food fed each 
day were due to lessening the water and thus making a more 
concentrated food. The meals were too large in bulk, but 
as he had, been very much overfed during the first four 
months, it was difficult to reduce them enough and still 
satisfy the demands of an enlarged stomach. 



579. 



SCHEDULE No. 7 



Age, 
days 


Cream, 


Skim- 
milk, 


Boiling 
water, 


Lime- 
water, 


Starch, 


Milk- 
sugar, 


Solid 
Food 


Total 

Amount 


Weight, 




oz. 


tea. 


oz. tea. 


oz. tea. 


oz. tea. 


oz. tea. 


oz. 




oz. tea. 


lbs. oz. 


37 


1 


3 


2 


9 






Va 




13 3 


8 


42 


2 




2 3 


12 






l 




17 3 


8 12 


48 


2 




2 4 


12 






l 




17 4 


9 8 


56 


2 




3 


13 






l 




19 


10 


63 


1 


3 


3 1 


14 






l 




19 4 


10 8 


70 


1 


4 


3 3 


14 3 






l 




20 4 


10 14 


76 


1 


5 


3 4 


15 






l 




21 3 


11 4 


85 


2 




4 


14 3 






l 




21 3 


11 14 


91 


2 




4 4 


14 






l 




21 4 


12 2 


98 


2 


3 


5 1 


14 






l 




22 4 


12 5 


105 


3 




6 


13 






i% 




23 


13 


112 


3 




6 1 


12 






l 2 A 




22 1 


13 4 


119 


3 




6 3 


10 






2 




20 3 


13 12 


126 


2 




7 


11 3 






2 




21 3 


14 


133 


1 




7 2 


13 


1 3 




2 




22 5 


14 4 


140 







14 


24 


2 




Wa 




40 


14 10 


147 







17 3 


23 


2 




i% 




42 3 


15 


154 







18 2 


23 


2 




1% 




43 2 


15 5 


164 







15 4 


25 4 


2 




2 




43 2 


15 10 



222 



FEEDING RULES FOR INFANTS 









SCHEDULE No. 7— 


Continued 






Age, 
days 


Cream, 


Sk 
mi 


im- 
lk, 


Boiling 
water, 


Lime- 
water, 


Starch, 


Milk- 
sugar, 


Solid 
Food 


Total 
Amount 


Weight, 




oz. tea. 


oz. 


tea. 


oz. 


tea. 


oz. 


tea. 


oz. tea. 


oz. tea. 




oz. tea. 


lbs. oz. 


173 





16 


2 


25 


4 


2 






2 




44 


15 13 


181 





17 


3 


26 


2 


2 


2 




2 




46 1 


16 


189 





19 




27 


4 


2 


2 




2 




49 


16 4 


196 





21 


2 


31 


2 


2 


2 




24 




55 


17 


202 





24 


3 


31 


2 


2 


1 




2/ 2 




58 


. 17 


209 





24 


2 


30 




2 




Rice 


24 




56 2 


17 3 


216 





23 




29 




2 




water 


2 




54 


17 6 


224 





22 


3 


28 


3 


2 




and 

oat 

water 


13/4 




53 


17 10 


231 





23 


2 


27 


4 


2 




134 




53 


18 8 


238 





26 




27 


3 


2 




1 


1/2 




56 3 


18 10 


245 





28 




25 




2 




3 


154 




58 


19 12 


252 





28 




23 


_ 


2 




5 


1 




58 


20 


259 


Crusts, 


29 




21 


4 


2 




7 2 


M 




60 


20 8 


266 


toast, 
bread, 
crack- 


29 




20 


4 


2 




8 2 


M 




60 


20 12 


272 


30 


2 


19 


2 


2 




10 5 


Vi 




62 3 


20 12 


279 


ers and 


30 


2 


18 


3 


2 




11 4 


Va 




62 3 


21 


286 


dry 
starches 
of all 


31 


2 


18 


1 


2 




13 3 







65 


21 6 


293 


32 




16 


3 


2 


1 


17 2 







68 


21 10 


302 


kinds 


33 


2 


14 


4 


2 


2 


19 4 







70 


22 


310 




34 


5 


12 


2 


2 


3 


22 2 







72 


22 8 


316 




34 


5 


9 


5 


2 


3 


24 5 







72 


22 8 


322 




31 


3 


9 




2 


2 


22 3 







65 2 


22 8 


328 




31 


2 


7 


5 


2 


1 


23 3 







64 5 


22 8 


334 




31 


2 


5 


4 


2 


1 


25 *4 







64 5 


22 8 


341 




30 


3 


4 




2 




26 3 







63 




349 




30 




2 




2 




27 3 







61 3 




357 




30 




1 




2 




28 3 







61 3 




365 




28 


4 







2 


3 


28 5 







60 


23 


371 




27 









3 




33 







63 




377 




14 


2 







3 


4 


50 







68 


23 


383 




19 


1 







3 


2 


43 







65 3 




389 




20 


1 







3 




36 3 







59 4 




396 




18 


2 







2 


3 


35 1 







56 




403 




17 









2 


2 


33 1 







52 3 


23 


409 




15 


2 







2 




30 4 







48 


23 


415 




17 


5 







2 


2 


31 5 





Eggs, 


52 


24 8 


421 




15 


2 







2 




26 4 





crack- 


44 


24 8 


427 




15 









2 




27 





ers, 


44 


25 


433 




15 









2 




27 





toast, 


44 


26 


439 




15 









2 




27 





po- 
tatoes 


44 


26 


445 




15 









2 




27 







44 


26 


452 




12 


3 







1 


3 


22 







36 


26 


458 


- 


11 


1 







1 


2 


19 3 







32 


26 8 


464 




7 


4 







2 




26 2 







36 


26 8 



Complete weaning was accomplished with this child when 
he was 140 days old. 



FACTS TO BE NOTED 



23 



The following analysis shows the amount of food fed 
daily at different ages for each pound of the infant's 



weight 



Age 


>> 

CO 


en 

O 
£ 


co a 

B 


A 

■M 

O 

£ 


1 


E 


O 

s 


C/3 

O 

Fi 






Weight, lbs 


8 


10/ 


12/8 


1334 


15/ 


16 


17/ 


Cream, teaspoons 


1 
1/ 


1 


1 

2/ 


154 

234 




7 



6/ 





Skim-milk, teaspoons 


8 


Total 


2/ 


234 


m 


4 


7 


6/ 


8 




Age, months 


8 


9 


10 


11 


12 


13 


14 


15 


Weight, lbs 


19^4 


2054 


22 


22/ 


23 


23 


24/ 


26 


Cream, teaspoons 

Skim-milk 




8/ 






9 






7/2 



5/ 



33/ 




3/ 


Total 


8/ 


m 


9 


m 


7/2 


5/ 


33/ 


3/ 



Milk-sugar varied from one-eighteenth during the first 
two months to one-twenty-third at six months of the food 
and water combined. 

A comparison of the amounts of skim-milk fed with those 
amounts of it and cream fed to the infants in the other 
schedule shows, beyond a doubt, that very little of the 
cream was removed in the process of setting the milk for 
this infant. One great advantage this child enjoyed 
was the newness, richness and purity of the milk. This is 
always an immense assistance in feeding an infant, which 
mothers living in large cities can seld.om enjoy. The milk 
was always used in its raw state, but pepsin was given at 
times to assist the digestion. 

This baby lived 150 miles distant from the writer, who 
was called to arrange his diet when he was thirty-six days 
old. He was nursing his mother, but her milk was insuffi- 
cient and also of poor quality and he was suffering continu- 
ally from colic and green, slimy stools. 



224 FEEDING RULES FOR INFANTS 

As the parents owned their own cow, partly Jersey in 
breed, she supplied all the fresh milk necessary for the 
food. The cow's food was hay or grass, with bran or 
ground grain as a mash, and the milk was rich in fat. 

This infant proved to have very good digestive organs 
and his progress was continually forward, with the excep- 
tion of slight digestive disturbances when fed too much. 
He had no sickness of any kind until he was nearly two 
years old. He was nursed partly during the first four -and 
one-half months. Increases of cream were borne well until 
he was four months old, when it caused vomiting and some 
looseness of the bowels ; but, as the mother was a very gen- 
erous feeder, believing fully in the necessity of feeding 
plenty of cream, this overfeeding was not surprising. As 
she set the milk for a few hours in order to remove the 
cream, she was not particular in the time she waited or in 
taking it all off when she skimmed the milk This will 
explain the absence of cream in the dietary after four 
months. Evidently, enough of it was left in the skim-milk 
to meet all the necessities of the infant. 

Skim-milk was fed to the highest point possible without 
producing curds or foul-smelling stools, and as it was 
always new and clean, it was given in its raw state. The 
amount of it fed in this case, from nine to twelve months, 
was higher than usual with such rich Jersey milk, and was 
more than was beneficial to the infant, for it will be noted that 
the advances in weight were slow, or none, until this food, 
and, water also, were reduced in quantity and starch 
increased when the child was about a year old. 

The proportion of milk-sugar was higher than was com- 
monly given, as the baby seemed to digest it perfectly and 
thrive well. It varied from about one-tenth to one-twentv- 



INFANTS WHO DO NOT GROW 225 

fifth of the whole day's food, but the high percentage was 
evidently too much, as it was continued only for a short 
time when the baby was 110 to 130 days old. Over-feeding 
of sugar, as usual, caused redness and irritation about the 
rectum and also soft, splashy stools. It was gradually 
reduced and finally omitted as starch was sufficiently 
increased. 

Rice and oat water were gradually introduced after seven 
months. They were used in combination or separately as 
the stools demanded the softening qualities of the oatmeal 
or the drying qualities of the rice. Bread crumbs and 
crackers were also commenced in small quantities at nine 
months and other substitute foods, such as eggs and pota- 
toes, were added. 

This infant was on a practically solid dietary when it 
was fifteen months old. The starch-waters were commenced 
in standard strength — one tablespoonful of the meal or 
flour, or two tablespoonfuls of the flakes, to one pint of 
water — but this strength was increased as the infant grew 
older and demanded more food to carry it from one meal to 
the next. 

As this child was seen by the writer only once, all farther 
changes in the diet were made from the charts which the 
mother filled regularly and forwarded by mail. 

INFANTS WHO DO NOT GROW 

580. This is a condition which appears in many infants 
and causes mothers very frequently to increase the food 
beyond the limited amounts which are safe for the little 
one. They do this because they think the failure to grow 
is entirely due to an insufficiency of food. The foregoing 
schedules, it is hoped, will be a general guide to mothers 

15 



226 FEEDING RULES FOR INFANTS 

regarding the amount that is sufficient according to the 
infant's weight. They also show where infants grow as 
well, or better, on reduced amounts of food. 

Where an infant does not grow when, apparently, receiv- 
ing enough food, mothers should remember that foods of 
the same name and of equal weight- are not always the same 
strength or do not carry equal nourishing powers. This is 
strongly illustrated in paragraph 133, showing the great 
variation in strengths of different samples of milks. 

Where an infant is receiving enough food as per sched- 
ules and shows no increase in weight, the foods should be 
changed gradually for others of the same name ; milk-sugar 
replaced by cane-sugar or grape-sugar; that is, a malted 
starch, such as Mellin's Food ; cream or butter fat by cod 
liver oil or sweet oil ; proteids by another sample of skim- 
milk or a newer one, by meat teas or juices or by egg albu- 
mens ; and baked or boiled starches by those differently 
prepared or those having a different flavor and taste. These 
changes should always be made before increasing the food 
beyond reasonable amounts. 

ADVANTAGES OF DRY FOODS 

581. The hand-fed infant is consuming the same foods 
as the adult, even though not in the same form. The sali- 
vary secretions commence about the third month, and by 
this, nature shows her readiness to digest some starch. 
When starch is mixed with milk, the length of time it 
remains in the mouth is not sufficient to accomplish the 
dextrinizing action of the saliva. How much saliva is drawn 
by the nursing process cannot be ascertained, but it 
cannot be equal to that demanded by dry food (302). In 
order to utilize the saliva, an effort should be made to feed 



FILLED CHARTS 227 

starch in the dry form as soon as the infant will accept it 
after drooling- commences, usually about the eighth month. 
This can be done by using bread crusts or crumbs, gluten 
biscuit, crackers, toast, etc., all of which demand saliva to 
moisten them and thus stimulate a large salivary secretion 
which quickly dextrinizes all forms of starchy foods. This 
is always the first change requisite in converting this food 
into healthy aliment (252). 

582. Another very decided advantage in feeding the dry 
starches is the stimulating influence which new tastes in 
foods give to the secretion of digestive fluids. This is similar 
to the experience of the adult who enjoys a fresh relish for 
each new course at the dinner table. Even though the 
foods be all starch, the new forms and flavors stimulate 
the infant to better digestion, and,, consequently, give better 
results than when only one form is continued for a long time 
without any change. 

583. In the foregoing schedules, different varieties of 
starch were used with the milk as long as they produced 
healthy stools, and as soon as the infant would take dry 
bread or cracker crumbs, they were given regularly every 
day. Very great harm is continually done by giving bottle 
food too liberally, too dilute or too long, and mothers must 
be careful to reduce the size of some meals when they add 
any quantity of dry starches to the daily dietary. 

FILLED CHARTS 

The following five filled charts show the actual work of as 
many mothers. Some show good and others fair progress 
and illustrate the advances of different infants according to 
their digestive power. * 



228 



FEEDING RULES FOR INFANTS 



584. Baby H — d, Residence, 



Age 10 weeks 



1. Year 

Month July 


Day 

29 


30 


31 


Aug. 
1 


2 


3 


4 


2. Cream 


Oz.Tea 

2 3 


Oz.Tea 
2 3 


Oz.Tea 

2 3 


Oz. Tea 
2 3 


Oz. Tea 
2 3 


Oz.Tea 

2 5 


Oz.Tea 

2 5 


3. Human milk .... 


5 


5 


5 


5 | 5 


5 


5 


4. Skim-milk 


6 4 


6 4 


6 5 


6 5 | 7 


9 


9 


5. Whey 








I 










6. Lime-water 


4 


4 


4 


4 1 4 


4 


4 


7. Boiling water. . . 


13 3 


13 3 


13 3 


13 3 


13 3 


16 


16 


* Sugar j^ ::;; 
















9. Starch 




















10. Unused Food. . . 


3 


2 3 


1 4/ 


1 3 


3 




6 3 


( Albumen 

11. ] Beef Tea 

( Beef Juice 
















12. Feed How Often 
















13. Day Meals 

6A.M.I No. 

to ] 
6 P. M. ( Size 


7 1 

3/3/ 


5 2 
3^/3/ 


4 3 

3/334 


3 4 

3/2334 


1 6 

3/334 


1 5 

3/334 


1 5 

3/334 


14. Night j No. 
Meals } Size. 


2 
4 


3 

4 


3 

4 


3 

4 


3 

4 


3 1 

4 4/ 


3 1 

4 4/ 


15. Whole Day's 

Food 


36 


36 3 


37 1/ 


37 3 


38 


38 3 


38 3 






16. Spits 


Little 
No 


No 
No 


No 
No 


No 
No 


No 
No 




No 


Vomiting 


No 


17. Whole Number 
of Meals 


10 


10 


10 


10 


10 


10 


10 


18. Medicine 


Peptonized the milk. 


19. No. of Stools... 


1 


2 


2 


1 


2 


3 


1 


20. Color 


Yel. 


Yel. 


Yel. 


Yel. 


Yel. 


Yel. 


Yel. 


21 - Oior | Natural. 


Nat. 


Nat. 


Nat. 


Nat. 


Nat. 


Nat 


Nat. 


( Splashy. . 

22. Kind] Soft 

( Formed. . 


Soft 


Soft 


Soft 


Soft 


Soft 


Soft 


Soft 


2aColic iNo s :::::: 


No 


No 


No 


No 


No 


No 


No 


24. Weight 


n uy 2 


11 15 


11 15 Ji 


12 2/ 


12 3 


12 3 


12 5 


ok rv„ \ Natural. . . 
25. Gas j More 


Nat. 


Nat. 


Nat. 


Nat. 


Nat. 


Nat. 


Nat. 


2 «- G -JDo- w „::::: 


Little 


Little 


Little 


Nat. 


Nat. 


Nat. 


Little 


a7 - Sleep] fc;;; 


Good 

<< 


Good 

«< 


Good 


Good 

<< 


Good 


Good 


Good 
<< 



FILLED CHARTS 



229 



28. Temper j <£»£ 


Good 


Good 


Good 


Good 


Good 


Good 


Good 


29. Hungry ( How 
Before •< Many- 
Meals ( Min't's 


5—10 


5—10 10—15 


5—10 


5—10 


5—10 


5 



This infant was hand-fed from birth. He had difficulty 
in digesting his food during the first two weeks, as he had 
many green, mucous stools with much colic. His food was 
not peptonized at that time and when two weeks old, six 
ounces of human milk were added to his dietary daily. 
After this, his stools became yellow and only an occasional 
green one appeared. When five weeks old, the cow's milk 
was peptonized, and from that time he remained always 
happy and his growth was so rapid that the only apprehen- 
sion was lest he should grow too rapidly. Peptonizing was 
continued for six months. Human milk was stopped at three 
months. He had great digestive power and demanded so 
much food that the rule to increase food only at one point 
in any day was not observed. This would be dangerous with 
a weak digester. 

His chart shows the following important features : 

1st. — Food increased in quality and quantity on the same 
day. This was possible when human milk was part of the 
dietary in an infant with good digestive power. 

2d. — Irregularity in number of stools is safe with human 
milk but not when it is absent. 

3d. — Item 22 shows soft stools. This is also due to the 
human milk and safe when the odor is natural, thus showinp- 
no decomposition of the food. 

4th. — Item 2G shows a little gas coming up. This was 
due to crowding the stomach a little too much. Item 29 
shows he was fed as soon as he became hungry. This could 
not have been done with soft stools except when made from 
human milk. 



230 



FEEDING RULES FOR INFANTS 



585. Baby R., Residence 



Age 3 months 



1. Year 1905 

Month April 


Day 

29 


30 


1 


2 


3 


4 


5 


2. Cream 


Oz.Tea 
1 3 


Oz.Tea 
1 3 


Oz.Tea 
1 3 


Oz. Tea 

2 


Oz.Tea 
1 3 


Oz.Tea 
1 3 


Oz.Tea 
1 3 


3. Human milk. . . . 
















4. Skim-milk 


7 2 


7 3 


7 3 


8 5 


7 4 


7 4 


7 4 


5. Whey 




















6. Lime-water 


2 


2 


2 


2 


2 


2 


2 


7. Boiling water. . . 


20 


20 


20 


25 


20 


20 


2o 


*s»HS£ ::: . : 


1 3 


1 3 


1 3 


1 3 


1 3 


1 3 


1 3 


Q j Starch 

y ' I Flour 






1 


1 


2 


2 


2 






10. Unused Food. . . 
















( Albumen 

11. ] Beef Tea 

( Beef Juice 
















12. Feed How Often 
















13. Day Meals 

6 A. M. ( No. 

to ] 
6 P. M. ( Size 


7 
*15 17 


7 
15 17 


7 
16 17 


7 
16 17 


7 
17 


7 
17 


7 
17 


14. Night j No. 
Meals ( Size 


3 

*22 


3 

22 


3 
23 


3 

23 


3 
23 


3 

23 


3 

23 


15. Whole Day's 

Food 


29 1 


29 1 


30 3 


31 2 


31 2 


31 2 


31 2 


16. Spits 


No 


No 


No 


No 


No 
« 


No 


No 


Vomiting 


a 


17. Whole Number 
of Meals 


10 


10 


10 


10 


10 


10 


10 


18. Medicine 























19. No. of Stools:... 


1 


1 


1 


1 


1 


1 


1 


20. Color 


Yel. 


Yel. 


Yel. 


Yel. 


Yel. 


Yel. 


Yel. 






21 -°<HFo a :r!: 


Nat. 


Nat. 


Nat. 


Nat. 


Nat. 


Nat. 


Nat. 


( Splashy. . 

22. Kind] Soft 

( Formed. . 


Formed 


Formed 


Formed 


Formed 


Formed 


Formed 


Formed 


23 - Colic |no s ::::: 


No 


No 


No 


No 


No 


No 


No 


24. Weight 


lb. oz* 

8 12 


lb. oz. 

8 11 


lb. oz. 

8 12 


lb. oz. 

8 13 


lb. oz. 

8 14 


lb. oz. 

8 15 


lb. 
9 


25. Gas|^ atura1 --- 
{ More 


Nat. 


Nat. 


Nat. 


Nat 


Nat. 


Nat. 


Nat. 


26. Gas] ^P 

( Down .... 


Nat. 


Nat. 


•Nat. 


Nat. 


Nat. 


Nat 


Nat. 



FILLED CHARTS 



231 



^•siee-pjfe;; 


Good 


Good 


Good 


Good 


Good 


Good 

<< 


Good 


28. Temper jg^; 


Good 


Good 


Good 


Good 


Good 


Good 


Good 


29. Hungry ( How 
Before -J Many 
Meals ( Min't's 


15 


15 


5 


5 


5 


5 


5 


30. Temperature. . . . 
















11 tt-,\,~ i Natural . 
31. Urine j Strong 
















32. Genitals 
















33. Abdomen 
















34. Skin 
















35. Head 
















36. Veins 
















37. Flesh 
















38 Bones 





















* Figures in 13 and 14 indicate teaspoons. 

6 flat teaspoons or 2 flat tablespoons make one ounce. 

This is the second infant in this family. The mother 
brought her first infant to the writer when four months old 
in a very emaciated and distressing condition, due to over- 
feeding it. On a very much reduced diet, she succeeded in 
making the infant happy and grow satisfactorily. This 
experience caused her to be over-careful in the amounts fed 
daily to this infant. 

She nursed it for a month, but as the baby had green 
stools all the time, suffered greatly from colic and did not 
grow, she was compelled to wean it. She then commenced 
feeding modified milk, but was unfortunate in getting poor 
milk from two careless, dirty dealers. In one bottle she 
found the green milk tickets which she had placed there to 
pay for the milk. The milk dealer had poured the milk 
into the bottle without any washing and brought it back 
next day. This arsenical milk-ticket juice caused a 



232 



FEEDING RULES FOR INFANTS 



diarrhea and vomiting. After a change to good milk, the 
mother was afraid to increase the food fast enough to give 
weight, although the chart shows everything correctly done. 

The following changes on the chart are important. Read- 
ing from left to right shows correct answers in the resulting 
items 16, 19, 20, 21, 22, 23, 25, 2G, 27 and 28. Such an- 
swers show perfect digestion and call for increase in food, 
such as are shown in items 9, 13, 11 and 15. Where the 
resulting items are correct, the increases may be made at 
two points, such as items 9 and 17, till the weight shows an 
increase of one ounce daily. After this, it is necessary that 
advances be made at only one point; that is, increase the 
whole amount of food or only one food each day; and this 
can be continued so long as the resulting items read cor- 
rectly. 

The reader will notice that in item 29, as soon as the 
child was fed within five minutes after becoming hungry, 
she increased in weight steadily. 



586. Baby L., Residence 








Age 5 weeks 


1. Year 1905 

Month April 


Day 
24 


25 


26 


27 


28 


29 


30 


2. Cream 


Oz.Tea 
4 


Oz.Tea 
4 


Oz.Tea 
4 


Oz.Tea 
4 


Oz.Tea 
4 


Oz.Tea 
4 


Oz.Tea 
4 


3. Human milk. . . . 
















4. Skim-milk 


4 


1 


1 


1 


1 


1 


1 


5. Whey 
















6. Lime-water 








Q 














7. Boiling water. . . 


18 


18 


18 


19 


19 


19 


19 


c \ milk .... 
8 - Su § ar |can e .... 


4/ 2 



o 4y 2 


o 4y 2 


o 4y 2 


4*/ 2 


4y 2 


4/ 2 


9. Starch 
















10. Unused Food. . . 
















( Albumen 

11. ] Beef Tea 

( Beef Juice 
















12. Feed How Often 

















FILLED CHARTS 



233 



13. Day Meals 

6A.M.I No. 

to ] 
6 P. M. ( Size 


7 
*10 11 


7 
10 12 


6 
10 12 


6 
11 13 


6 
11 13 


6 
12 13 




14. Night j No. 
Meals { Size 


4 

*12 13 


4 
10 13 


5 
10 13 


4 
11 13 


5 
10 13 


4 
12 13 




15. Whole Day's 

Food 


20 4 


21 


20 5 


20 1 


21 4 


20 2 




16 Spits 





























Vomiting 




17. Whole Number 
of Meals 


11 


11 


11 


10 


11 


10 




18. Medicine 


Peptonizing Powder 


19. No. of Stools . . . 


2 


2 


3 


3 


2 


2 




20. Color 


Yel. 


Yel. 


Yel. 


Yel. 


Yel. 


Yel. 




qi ru~- i Natural - " 
21. Odor| Foul _ 


Nat. 


Nat. 


Nat. 


Nat. 


Nat. 


Nat. 




{ Splashy. . 

22. Kind ] Soft 

( Formed.. 


Formed 


Fprmed 


Formed 


Formed 


Formed 


Formed 




» Colic 1 So.:: ::: 


No 


No 


No 


No 


No 


No 




24. Weight 


lb. oz. 

7 5 


lb. oz. 

7 7 


lb. oz. 

7 8 


lb. oz. 

7 9 


lb. oz. 

7 10 


lb. oz. 
7 9 




^-M"::: 


Nat. 


Nat. 


Nat. 


Nat. 


Nat. 


Nat. 




26-Gas|gP wn -;:;; 
















27 - s HSfg y hY::: 


Good 
<< 


Good 


Good 


Good 

<< 


Good 

<< 


Good 




28. Temper | %£ 


Good 


Good 


Good 


Good 


Good 


Good 




29. Hungry ( How 
Before ■] Many 
Meals ( Min't's 


5 


5 


5 


5 


5 


5—10 




30. Temperature 
















qi tt,-;^ S Natural. 
31. Urine ] Strong< 
















32. Genitals 
















33. Abdomen 
















34. Skin 
















35 Head 




















36. Veins 
















37. Flesh 
















38. Bones 





















*The figures in 13 and 14 indicate teaspoons. 

6 flat teaspoons or 2 flat tablespoons make one ounce. 



234 



FEEDING RULES FOR INFANTS 



This little fellow was hand-fed from birth. His mother 
had great trouble in feeding an older child, and, conse- 
quently, was prepared for correct work with this one. This 
chart shows correct work done by an intelligent nurse. It 
illustrates proportions of foods at this age and good results 
following their use. 

The reader will note the following points : j 

1st. — Increases in skim-milk and the whole amount of 
food daily on th@ 25th. This was wrong, as the weight 
increased 2 ounces on that day, but was corrected by 
increasing item 7 next day, thus diluting the food. 

2d. — Item 15 was increased, rapidly, as baby had not been 
growing as much as is desirable at that age. This rapid- 
ity is allowable for a week or ten days only. 

3rd. — Irregularity in number of meals, item 17, is wrong, 
but is unavoidable here as baby became hungry before 6 A. 
M., some days and after on other days. He was, properly 
speaking, taking ten and one-half meals daily. 

4th. — Item 18. Peptonization of the milk and cream 
was needed to remove green color from the stools and check 
the colic from which he suffered during the first two weeks. 

5th. — All the answers showing results are correct and 
thus allowed the baby to be always fed as soon as h» became 
hungry. 



587. Baby G., 


Residence 








Age 7 weeks 


1. Year 


Day 
6 


7 


8 


9 


10 


11 




Month, Sept 


12 


2. Cream 


Oz.Tea 
1 1 


Oz.Tea 
1 1 


Oz.Tea 
1 1 


Oz.Tea 
1 1 


Oz.Tea 
1 1 


Oz.Tea 
1 1 


Oz.Tea 
1 


3. Human milk 


6 


6 


6 


6 


6 


6 


6 


4. Skim-milk. . . 




2 3 


2 3 


3 


2 


2 


2 


2 1% 


5. Whey 





















FILLED CHARTS 



235 



6. Lime-water 


2 


2 


2 | 2 | 2 


2 I 2 


7. Boiling water. . . 


18 


18 


18 118 |18 


18 |18 


*s«H ££:::: 
















9. Starch 




















10. Unused Food. . . 
















( Albumen 

11. ] Beef Tea 

( Beef Juice 
















12. Feed How Often 
















13. Dav Meals 

6 A. M. ( No. 

to ] 
6 P. M. ( Size 


7 
*6 21 


7 
6 21 


8 
9 15 


6 
12 15 


7 
6 15 


7 
9 15 


7 
9 15 


14. Night j No. 
Meals ( Size 


6 
*12 18 


5 
12 21 


3 

12- 15 


5 

12 15 


5 
12 15 


6 
6 18 


7 
6 18 


15. Whole Day's 

Food 


28 3 


2G 


24 3 


23 3 


24 3 


27 3 


26 3 


16. Spits 


1 


2 


1 


3 


1 


1 




Vomiting 


1 


17. Whole Number 
of Meals 


13 


12 


12 


11 


12 


14 


14 


18. Medicine 
















19. No. of Stools . . . 


2 


2 


3 


2 


2 


1 


2 


20. Color. 




lyel. 
ldark 


Yel. 


Dark 


Green 


Green 


Dark 






Dark 


91 r\A n ~ \ Natural.. 
21. Odor ?Foul 


Foul 


Foul 


Foul 


Foul 


Foul 


Foul 


Nat. 


( Splashy. . 

22. Kind] Soft 

( Formed.. 


Soft 


Soft 


1 soft 

Formed 


Splashy 


Splashy 


Soft 


Soft 

Formed 


23 - c ° lic {No s :::::: 


No 


Yes 


Yes 


No 


No 


No 


No 


24. Weight 


lb. oz. 

9 


lb. oz. 
8 12 


lb. oz. 

8 12 


lb. oz. 
8 12 


lb. oz. 

8 12 


lb. oz. 

8 12 


lb. oz. 
8 12 


25 -MMor u e ra !::: 


Nat. 


Nat. 


More 


More 


Nat. 


Nat. 


Nat. 


26 -Gas)UP wn:::; . 


Yes 




Yes 


Yes 


Yes 


Yes 


Yes 


27. Sleep 


Day 

Night... 


Fair 
Good 


Fair 
Good 


Fair 
Good 


Poor 
Good 


Fair 
Good 


Fair 
Good 


Good 
Good 


28. Temper] Good.. 
v ( Cross . 


Good 


Cross 


Cross 


Good 


Cross 


Cross 


Good 


29. Hungi 
Before 
Meals 


y i How 
■J Manv 
( Min't's 


15 


15 


15to20 


20 


15 


15 


15 



* Teaspoonfuls. 



236 FEEDING RULES FOR INFANTS 

This is the second baby of parents who were very anxious 
and worried because they had lost their first one through 
unsuitable dietary. As the mother had not enough nurse 
for it and also because what she did give disagreed, the 
infant was weaned. A milk mixture was tried and failed 
to satisfy or nourish it. When he was six weeks old, the 
writer first saw the little one. He was very pale and thin, 
though a large baby. 

This chart is shown as an illustration of what was done 
by an over-anxious mother, worried and losing her sleep. 
The cries of the infant caused by indigestion, were mis- 
taken for hunger and too much food was given. Vomiting 
warned her of overfeeding, bnt her desire to feed more 
caused her to repeat this mistake again as soon as there was 
less vomiting. 

The general irregularity in items 15 and 17 caused bad 
and irregular results, as shown in items 16, 19, 20, 21, 22, 
23, 24, 25, 26, 27, 28 and 29. In none of these items does 
the work show good results nor yet does the child improve. 
The good effects which should follow lessening of sugar and 
skim-milk were entirely frustrated by the irregular amounts 
fed from day to day. This mother was like many others, 
too anxious, and not having fixed ideas of what was right, 
changed her plans continually with the cries of the infant 
or the importunities of friends. In a few weeks, she became 
tired of this and realized that she must follow the physician's 
directions or lose her infant. She then did systematic- work 
and only made such changes as the stools and comfort of 
the baby demanded. From this time forward, her progress 
was satisfactory and her baby thrived perfectly. 

The general directions given her were to lessen some or 



FILLED'CHARTS 



237 



all of the foods till the gassy condition was removed and 
the stools showed formation, and then to increase gradually 
inside the gassy condition, always keeping the stools 
formed. This plan was successful and made a happy mother 
as well as a happy child. 



588. Baby H— y 


., Resi 


dence 






Age 20 


weeks 


1. Year 1904 

Month Nov 


Dav 
18 


19 


20 


21 


22 


23 


1 


2. Cream 


Oz.Tea 
1 1 


Oz.Tea 
1 1 


Oz.Tea 
1 1 


Oz.Tea 
1 1 


Oz.Tea 
1 2 


Oz. Tea 
1 3 


Oz. Tea 
1 3 


3. Human milk. . . . 
















4. Skim-milk 


14 


14 


14 


14 


14 


14 


14 


5. Whey 
















6. Lime-water .... 


2 


2 


2 


2 


2 


2 


2 


7. Boiling water. . . 


24 


24 


24 


24 


24 


24 


24 


8. Sugar ■ 


Milk .... 
Cane. . 


2 


2 


2 


2 


2 


2 


2 


9. Starch 


( Imp 

Gran . . . 


3 


3 


3 


3 


3 


3 


3 


10. Unused Food. . 
















( Albumen 

11. •] Beef Tea 

( Beef Juice 
















12. Feed How Often 












1 


13. Day Meals 

6 A. M. ( No. 
to ] 

6 P. M. ( Size 


4 3 
3 2/ 2 


5 2 
3 2/ 2 


6 1 

3 2/ 2 


3 4 

2y 2 3 


6 1 
3 4/ 2 


5 1 
3K 4 


5 1 1 
33^4 


14. Night j No. 
Meals I Size 


4 1 

4 2/ 2 


4 
4 


4 


5 
4 


3 

5 


3 

5 


3 1 
5 3 


15. Whole Day's 

Food 


38 


36 


36 3 


39 3 


37 3 


36 3 


40 3 


16. Spits 


1 



2 








3 












3 


Vomiting ' 





17. Whole Number 
of Meals 


12 


11 


10 


12 


10 


10 


11 


18. Medicine 


Peptonized the Milk. 


19. No. of Stools... 


1 


1 


1 


1 


2 


2 


2 


20. Color 


Yel. 


Yel. 


Yel. 


Yel. 


Yel. 


Yel. 


Yel. 






oi r\A„^ J Natural. 
21. Odor } Foul 


Nat. 


Nat. 


Nat. 


Nat. 


Foul 


Foul 


Foul 


( Splashy. . 

22. Kind] Soft 

( Formed . 


Formed 


Formed 


Formed 


Formed 


Soft 


Soft 


Formed 



238 



FEEDING RULES FOR INFANTS 



23. Colic \ Y« ;;;•• 


No 


No 


No 


No 


Yes 


Yes 


No 


24. Weight 


lb. oz. 

9 7 


lb. oz. 

9 12 


lb. oz. 

9 12 


lb. oz. 

9 1J 


lb. oz. 

9 11 


lb. oz. 

9 11 


lb. oz 

9 ny 2 


^•Gas]Nat-al ;; . 


More 


More 


More 


Nat. 


Nat. 


Nat. 


. Nat. 


2 «-Gas|Up wn ;; ::: 


Both 


Both 


Both 


Both 


Both 


Both 


Both 


27 - sl Hfe::: 


Fair 


Fair 


Well 


Poor 


Well 
Poor 


Fair 


Good 


28. Temper j good. 


Good 


Good 


Good 


Cross 


Cross 


Good 


Fair 


2y. Hungry ( How 
Before ■< Many 
Meals ( Min't's 


Could not tell. 


30. Temperature .... 












1 


qi tt^;«« I Natural. 
31. Urine j Strong 
















32. Genitals 
















33. Abdomen 
















34. Skin. 




















35. Head 
















36. Veins 
















37. Flesh 
















38. Bones 





















6 flat teaspoons or 2 flat tablespoons make 1 ounce. 

This infant nursed a few weeks, was then weaned and 
fed, a cream mixture, but, as they were living at their sum- 
mer home, they could not control the milk supply. As the 
mother was sick herself, the baby did not progress satisfac- 
torily. A short review of the different items reveals some 
of the difficulties appearing commonly in infants who are 
unsuccessfully nursed and also improperly fed afterwards. 

Item 2 shows a low amount of cream. This always fol- 
lows overfeeding of this item an4 the daily amount never 
reached 2 ounces. 

Item 4. Skim-milk is high, being nearly 1J ounces daily 
for each pound of the infant's weight. When he was ten 
months old and weighed eighteen pounds, he could not take 
16 ounces daily. His power to digest milk foods was poor. 



FILLED CHARTS 239 

Item 5. Irregularity in amounts fed daily is always a 
failure if continued long. 

Item 6 shows the stomach was overloaded on some days. 

Item 7. The proportion of water must always be high 
when correcting errors from overfeeding where too large 
meals are given. It was gradually reduced. 

Item 8 shows full proportion of sugur. This item had been 
fed too low. 

Item 9. Imperial granum, rice flour and oat flakes were 
gradually increased as he grew in weight. 

Item 13 shows irregularity in size and number of meals. 
This is the usual experience of a mother when finding the 
amount suited to impaired digestive secretions. 

Item 17. The number of meals must be uniform. Only 
reductions in number are correct as age increases. 

Item 18. Milk must always be predigested when diges- 
tion of it is imperfect. 

Item 19. The increased food of the 21st was not all 
digested and two soft, foul stools followed on the 22nd and 
23rd, with some colic also. 

Item 24. Evidently, weighing was not correctly done on 
the 18th, as there could not be a 5-ounce advance in actual 
weight in one day. The uniformity in weight after the 21st 
shows correct weighing, but also shows no advance. This 
is always the result with the irregularities shown in items 
15 and 17. A continual advance in food which produces 
correct stools is necessary to secure steadily increasing 
weight. 

The irregularities in items 25, 26, 27 and 28 always follow 
irregularities in items 15 and 17, and it is impossible to 
answer item 29 when the stomach is not healthy or is im- 
properly used. 



CHAPTER IX 

SUMMARY 
FEEDING RULES 

589. No. 1. — Slow feeding always; intervals of amuse- 
ment between courses ; no bolting of food. 

590. No. 2 — All food which does not melt down with 
water must be thoroughly softened by cooking and mash- 
ing. Children seldom chew their food enough. 

591. No. 3 — Never urge a child to eat more. Do not 
procure other foods when the proper ones are refused. 
Change the food at the next meal, if it is a fatty one like 
those made with cream dressings. Never tempt the appe- 
tite with fruits (774) or sweet goods (772) ; always wait 
till the next meal, when a good appetite is present. If food 
is refused, do not lunch between meals. Always feed only 
that amount which will secure a good appetite for the next 
meal. Avoid night feeding after the first six months, as it 
always causes wakeful habits, and a cross, irritable and 
unsuccessful child. 

592. No. 4 — Sore mouth or throat demands liquid foods. 
Acute illness calls for a reduction of food and more drinks. 
Severe illness requires drinks only during the first few days 
and diluted milk or thin gruel as the sole diet afterwards. 

593. No. 5 — Hot weather always requires sterilized 
milk (148), smaller meals and more water in or with the 
food. A reduced milk dietary and more water are essential 
to maintain good health in summer (279). 

240 



PRACTICAL FEEDING 241 

591. What will you feed the newly-born baby? 

Four to five teaspoons of sugar-water at each feeding 
(103). 

One meal every six to eight hours the first day ; the same 
amount every three to four hours the second day with half 
teaspoon of very thick cream ; the same food on the third 
day, only more frequently, unless the mother is able to 
nurse the baby part of the time. 

595. If the mother's milk is not sufficient on the fourth 
day. what is the prospect of her being able to nurse the 
baby ? 

Most mothers, whose breasts are not crowded full with 
milk on the fourth day, will be unable to nurse their infants 
perfectly. 

596. Is it right for a mother to nurse her infant partly 
when she has not an abundance of milk? 

Yes; if her milk makes the infant sleep quietly and pro- 
duces yellow stools ; but, if it causes green, mucous or slimy 
stools after nursing three or four days, it is a great mistake 
for her to continue, as the more she nurses, the more injury 
will it cause to the future digestive power of the infant 
when the stools always continue to be green and slimy (35). 

597. - Do you consider green stools in the nursing infant 
proof of unsuitable dietary? 

Yes ; green in the stools is usually proof of unsuitable 
quality of milk. When accompanied by mucus or slime, 
it causes colic and crossness. A little green mixed with yel- 
low stool, when- there is no mucus therein, is not wrong; 
but green, mucous or slimy stools without any yellow color 
are always evidence of a serious condition. The danger 
grows in proportion with the increase of green and the 
absence of yellow (100). 

16 



242 FEEDING RULES FOR INFANTS 

598. Do green stools always show that the error lies in 
the food? 

No; many infants have very imperfectly developed diges- 
tive glands when born and cannot properly digest even 
good human milk (188). 

599. What food usually causes green in the stools of a 
healthy infant? 

Usually it is caused by excessive proteids in the mother's 
milk or by too much skim-milk in the dietary of the hand- 
fed infant. 

600. Can the milk of the mother be improved so as to 
correct the digestion and avoid green stools in the infant ? 

In many cases it can, where only parts of the stool show 
the green, slimy character. Changes in the food and avoid- 
ance of all medicine often give this improvement (42). 
Stools which are all or nearly all green and slimy usually 
demand, weaning. 

601. If these changes do not give heathy stools, what 
should be done? 

The infant should be partly fed on a cow's milk and cream 
mixture until the weak, tired mother regains her strength 
and is able to take exercise in the open air. These mothers 
often secrete a poor quality of milk, which causes green 
stools only temporarily (92). 

602. What foods should the nursing mother avoid? 
She should avoid fruits, cabbage, pickles, tomatoes and 

all sour drinks, as well as hearty meals which may cause 
indigestion. The mother suffering from indigestion always 
gives a colicky milk. Coffee is not a suitable drink and 
neither is milk (55). Meats, milk and eggs should be used 
in moderation, as much animal food makes a colicky milk 
(53). 



TRACTICAL FEEDING 243 

603. What drinks are most suitable to increase the 
mother's milk? 

Well-boiled gruels seasoned with milk or cream give the 
best results. They increase the amount and quality of the 
milk. Weak tea is also beneficial for this purpose (56). 
Beer and malt extract make more milk, but generally a poor 
quality. 

604. Will careful dieting of the mother improve the 
quality of her milk ? 

Yes ; if she naturally secretes a suitable milk ; but it will 
cause little improvement in a milk which always makes 
green, colicky, mucous stools (53). 

605. In what way must such infants be managed and 
fed? 

These infants must be weighed regularly every day on a 
reliable scale. As long as they gain in weight from four 
to seven ounces each week, they should continue to nurse, 
but as soon as they show gradually reducing weekly gain, 
with proper care of the mother, they should be weaned 
(486). 

606. Does this rule apply to infants of all ages ? 

Yes ; where weaning is delayed too long, the digestive 
glands will be so injured that it will be very difficult to feed 
the infant, and many weeks or even months may transpire 
before it will show any increase in weight after being most 
carefully weaned and given only those foods most suited 
to its weakened, digestive power (37). 

607. Do any of these children die because they are 
nursed too long? 

Yes; all of these infants become marasmic, more or less, 
and some of them die if a correct diet is not secured early; 



244 FEEDING RULES FOR INFANTS 

that is, before the digestive glands are seriously injured 
(88). 

608. x\re continuously green, mucous stools in the newly- 
born infant dangerous after it commences to nurse? 

They are very dangerous if the mother's milk does not 
produce some yellow color on the fourth or fifth day (706). 

609. How long can such nursing be continued? 

The infant should be weaned as soon as nursing fails to 
produce yellow stools. This requires only three or four 
days of nursing in the newly born infant or when it is six 
or seven days old (100). 

610. What foods would you give when weaning is 
demanded at six or seven days old? 

A very light cream from bottled milk sixteen to twenty 
hours old, diluted with four times as much boiling water 
and sweetened with one ounce of good milk-sugar or half 
an ounce of granulated to every fifteen ounces of the mix- 
ture. One ounce of lime-water may be added to every seven 
ounces of this and one to two tablespoons of the mixture 
fed to the infant about every two hours, or when it shows 
hunger. If the whole mixture is sterilized or pasteurized, 
it may be fed without adding the lime-water. 

611. Is there any difference in the cream that should 
be used? 

Yes; cream grows lighter and freer from milk in pro- 
portion as it becomes older during the first twenty-four 
hours. The power to digest skim-milk is very little in the 
new born infant, but increases with age. Gravity-made 
cream must be sixteen to twenty hours old and only the top 
of it from the bottle can be used during the first Week. As 
the infant grows older, larger amounts of cream can be 



PRACTICAL FEEDING 245 

taken off the bottle until three or more ounces are used daily 
when the infant is four weeks old (381). 

612. After an infant is three weeks old, what changes 
should be made in the diet? 

The proteid or skim-milk can be slowly added and 
increased as the infant's digestive power becomes stronger 
(231). 

613. What foods has the infant been receiving in the 
diluted cream and sugar-water during the first three weeks? 

The top of the cream is mostly composed of fat when 
taken from milk that stands in a bottle or mason jar from 
sixteen to tw r enty hours; but even in this light cream, there 
is a small per cent, of proteids and four and one-half per 
cent, of sugar. All of these are diluted in water, and with 
the addition of the seven per cent, of sugar in the sugar 
w r ater, make a food mixture which contains from two per 
cent, in the first week to three per cent, of fat in the third 
week; seven per cent, of sugar and one-fourth per cent, 
in the first week to one-half per cent, of proteids in the 
third, week (243). 

614. Can the infant continue. to thrive on this strength 
of food? 

No; the healthy imfant grows very rapidly during the 
first three months and requires great increases of food to 
make this growth (234). 

615. In what way should the diet be increased? 

As there are only three foods — fat, sugar and proteids — 
and baby has been taking all of them since it was born, 
the only way the diet can be increased is by giving more of 
one of these foods (243). 

616. How much can the sugar be increased,? 



246 FEEDING RULES FOR INFANTS 

The sugar is at seven per cent, now and that, usually, is 
the. largest amount an infant can digest perfectly, but with 
some, one or two teaspoonfuls of granulated sugar may be 
added to the daily food. 

617. What effect will sugar produce if it is fed too 
freely ? 

It will ferment and cause gas, colic, loose, splashy stools 
and a scalding redness in the bowels and around the rectum 
extending all over the hips, if the sugar is not decreased 
(409). 

618. How much can the fat in the diet be increased? 

To about four per cent, or three to four ounces daily in 
those who digest fat perfectly, but many cannot digest suc- 
cessfully more than one or two per cent (240). 

619. How will you know when too much fat is given and 
not digested perfectly? 

When it lessens the appetite; causes vomiting an hour 
or more after meals; produces crossness and a gassy con- 
dition; disturbs the sleep or loosens the bowels with foul- 
smelling, greasy or rancid, buttery stools (385). 

620. Can an infant thrive when overfed on fat or cream ? 
No; such a condition prevents growth, for it lessens 

the appetite and always gives the infant a pale yellow color 
(262). 

621. What purposes do sugar and fat serve in the infan- 
tile economy? 

They are consumed mostly as fuel to maintain the heat 
of the infant and the surplus is stored up as reserve fuel in 
the shape of fat. This is what gives the round, plump, 
pretty appearance to healthy, well-nourished infants (379 
and 403). 



PRACTICAL FEEDING 247 

6'32. How much can the proteids be increased? 

The amount to which proteids can be raised is somewhat 
uncertain, but they can be increased steadily as the infant 
becomes older. The newly born infant can digest only about 
one-quarter to one-half per cent, proteids, while the infant 
of six to eight months can digest from three to four per 
cent, or fifteen to twenty ounces of skim-milk daily if the 
additions are made gradually and without injuring those 
glands which digest this food (241). 

623. What purpose do the proteids serve as foods? 

All tissues and all repairs are grown from the proteids. 
The infant's growth and development are dependent upon 
the amount of this food that is received and properly 
digested (389). 

624. In what part of the milk are the proteids found ? 

In the skim-milk and some in the cream also ; but only a 
very small part in that very light top cream suitable to the 
newly born infant. 

625. How can you know when the proteids are over-fed? 
The infant becomes cross and colicky and cannot sleep 

comfortably, waking very often and crying out with pain. 
The stools become green, show much mucus and often 
curds also. In some cases, part of the stool will be formed 
and the balance soft and splashy with curds in it. In other 
cases, the stool will be formed and well digested but carry 
a few curds also (392). 

626. What makes curdy stools soft and splashy? 

Too much sugar in the diet, when skim-milk is much 
increased (392). 

627. Does the addition of skim-milk increase the pro- 
teids only? 

No; skim-milk contains four and one-half per cent, of 



248 FEEDING RULES FOR INFANTS 

sugar and one-fourth to one per cent, of fat in addi- 
tion to the proteids. This increase of sugar in the skim- 
milk will often cause splashy stools in infants who are 
already getting enough sugar. 

628. Which is the most valuable part of milk to feed 
to infants after the first month? 

Skim-milk ; for it carries all the foods — fat, sugar and pro- 
teids (95). 

629. If nature has given us only three foods and has 
provided digestive glands capable of digesting only these 
three foods, how do you classify starchy foods which are 
fed so freely to infants and adults? 

All starches are classified by nature as sugars, because 
they are converted into sugar by the digestive secretions 
(195 and 306). 

630. If that is so, will not the addition of starch to the 
dietary soon overload the sugar digesting glands? 

Yes;, the increasing of starch always increases the labor 
of these glands. 

631. What must be done then? 

The sugar must be decreased, steadily as the starch is 
increased (412). 

632. How soon must the sugar be decreased? 

As soon as the starch causes the gassy condition, looseness 
of the bowels or redness around and below the rectum 
(306). 

633. Which of these symptoms shows first? 
Generally, the redness below the rectum. 

634. When is it well to commence feeding starch? 
Very little can be fed during the first one or two months, 

but it can be steadily increased after that time if the child 
is not thriving on the other foods (303). 



PRACTICAL FEEDING 249 

635. Are the mineral salts in the cereals of any value ? 
Yes; they supply the lime and other minerals needed 

in making bones and teeth (192). 

636. Are infants injured and their development impaired 
by being restricted to human or cow's milk all the first 
year ? 

Yes; no mother can nurse an infant entirely and do jus- 
tice thereto -for a year (44). Few can nurse successfully 
more than six months, and no modified mixture of cow's 
milk can nourish an infant satisfactorily without an early 
addition of starch. All infants are improved by the addi- 
tion of good starchy food as soon as they can digest it 
properly (264). 

637. Is there much difference in the digestibility and 
nourishing qualities of the different cereals or starches ? 

They all differ somewhat. Oats are the most relaxing 
as they carry about eight per cent, of fat and cannot be fed 
where cream disagrees. Rice is the most easily digested 
and the most constipating. Wheat, barley and rice contain 
about one per cent, of fat and all make good infantile foods 
when properly prepared (307). 

638. Can starches be fed raw like milk ? 

No; all starches must be malted, baked or boiled in order 
to make them digestible (326). 

639. Which is the best way to prepare starch? 

There is no best way for all infants. That method of pre- 
paring and that form of starch which makes the infant 
happy in daytime and sleep well at night is always the best 
for that child (324). 

640. Are not all the proprietary foods made mostly of 
starch ? 

Yes; starch is the main ingredient in them (319). 



250 FEEDING RULES FOR INFANTS 

641. How is the starch prepared in them? 

The starch in Mellin's and Horlick's foods is prepared by 
malting. Nearly all the other foods are prepared by baking 
the starch (320). 

, 642. Is a boiled starch as suitable for infants as the 
malted or baked varieties? 

Yes ; for some infants and no, for others. Where a boiled 
starch is properly digested,, it is the best, as it is always 
fresh and sterile and the most economical form (307). 

643. What effect does malting have on starch and on 
the infant who is fed upon it ? 

It converts the starch into a grape sugar which may act 
as a laxative on the infant and cause scalding of the rectum 
and, hips. If it does not purge, it makes a nutritious food, 
very suitable to many delicate infants (320). 

644. What effect do baking and boiling have on starch? 

They partially dextrinize the starch, rupturing the cel- 
lulose envelopes containing it, thus allowing the digestive 
secretions free access to the starch itself (322). 

645. Is a food containing only starch or one containing 
starch with other ingredients the most suitable for infantile 
feeding ? 

Usually starch is added to a milk mixture in an infant's 
food. Where milk foods are well digested, a food contain- 
ing only starch should be added to it. This is the best food 
combination possible. When an infant cannot digest milk 
in any amount, some of the proprietary foods which can 
be fed without milk may be used temporarily (323). 

646. Can starch be fed in any form as the only diet of 
an infant? 

Neither starch, proteids, sugars nor fats can be fed as the 
only diet except for a short time. No infant can grow or 



PRACTICAL FEEDING 251 

thrive on any single food, and it is very difficult to do so 
on any two foods. The perfectly developed infant has 
required the largest proportion of each food — fat, proteids 
and sugar or starch — that it could digest perfectly. 

647. Are these foods obtained from cow's milk equal in 
digestibility and value with the same foods obtained in 
human milk? 

No ; especially during the first three to six months, the 
digestive power of the young infant has to be very gradually 
developed up to that point when it can partake of and assim- 
ilate enough of these foods from cow's milk to nourish it 
properly and enable it to grow satisfactorily. After three 
months of age, if it has been properly nursed or fed pre- 
viously, the infant is generally able to digest enough of 
these foods to give rapid growth and ample weight (292). 

648. Should there be regularity in the amount fed to 
infants from day to day? 

Yes ; unless this is observed, the feeding of the infant 
will be a repetition of mistakes and consequent digestive 
disturbances (651). 

649. Does this regularity apply to nursed as well as 
hand-fed infants? 

No; the nursing mother is often irregular in her nurs- 
ing. She cannot tell how much the infant is getting and 
generally lets it nurse till satisfied. If it has taken too much, 
it usually corrects the mistake by vomiting the surplus (86). 
Vomiting surplus human milk does no injury. The hand- 
fed infant cannot vomit in this way, as it is generally sick- 
ened and injured by so doing (450). 

650. How much may the amount fed daily vary without 
disturbing the infant? 

When an infant is properly fed and properly increasing 



252 FEEDING RULES FOR INFANTS 

in weight, an increase of more than one teaspoonful of any 
food oftener than every two or three days will soon cause 
indigestion, and a reduction of one ounce daily in the food 
mixture will cause loss of weight. 

651. Is it necessary to observe regular times of feed- 
ing? 

No and yes. In healthy infants who are digesting per- 
fectly and growing steadily, digestion is more rapid at some 
hours than at others and they require their meals somewhat 
irregularly to meet their variable hunger. This may demand 
a variation of half an hour sooner or later for some meals 
each day, but the aggregate daily amount of food must be 
always the same, save the necessary increase as the child 
grows heavier to nourish and support the extra weight' of 
the growing infant. Therefore, healthy infants — those who 
have healthy stools — must be fed when they become hungry. 

Sick infants with weak digestive power — those who have 
soft, foul, mucous or splashy stools — cannot tell or show 
when they are hungry, as their food is partly decomposing 
in them and causes distress and discomfort like hunger. 
Such infants must be fed at regular intervals and the food 
changed in amount or proportions until the stools show per- 
fect digestion and consequent formation. When this occurs, 
they become happy and can be fed when they become hun- 
gry, like healthy children are. 

G52. How should the times of feeding be regulated? 

The mother should not keep the healthy infant crying for 
food more than five to ten minutes when she knows it is 
hungry, nor should she look at the clock and think it nec- 
essary to feed whether the infant wants it or not, simply 
because feeding time (so called,) has arrived (505). If 
the infant is not calling for its food, it may be allowed to 



PRACTICAL FEEDING 253 

wait or if sleeping, it may not be disturbed for a few min- 
utes till it awakens. 

653. Which principle in feeding is most successful from 
the time point of view? 

That regularity which feeds the healthy infant within five 
to ten minutes after it becomes hungry. This means some 
irregularity in time, but must never allow irregularity in 
the whole amount fed each day (648). 

654. State the effect upon an infant when hungry and 
kept waiting for its meals. 

If, after the infant is hungry, it is compelled to wait 30 
minutes, it will lose 4 to 6 ounces in weight weekly; 20 
minutes, it will lose 2 to 3 ounces in weight weekly (503) ; 
15 minutes, it will not change weight much (502) ; 10 
minutes, it will gain 2 to 3 ounces weekly; 5 minutes, it 
will gain 4 to 6 ounces weekly (501). 

655. Does the infant digest all the food it receives? 
No; frequently, it cannot digest more than one-half the 

amount given to it. 

656. What becomes of this extra food which the infant 
cannot digest? 

It decomposes or sours in the stomach and bowels and 
causes crossness and irritability, and if the amount is large, 
it causes vomiting or diarrhea (450). 

657. Is this rotten food poisonous to the infant? 

Yes; when much of it is absorbed into the blood, it pois- 
ons the whole body and causes fever, convulsions and brain 
affections, besides kidney and bowel disturbances (698- 
701). 

658. What treatment must be adopted in these ;cases? 
The size of the meals must be reduced within the capacity 



254 FEEDING RULES FOR INFANTS 

of the digestive fluid secreted "for each meal, in order to 
show perfectly digested stools that are formed and free from 
bad or putrid odors (428). 

659. Do infants of the same size always secrete the same 
amount of digestive fluid for meals? 

No; some secrete much more than others, and an infant 
who has been wrongly or overfed enough to cause indiges- 
tion or diarrhea is seldom able to secrete as large an amount 
at each meal as it did before being thus sickened. 

660. How must such infants with limited digestive secre- 
tions be fed? 

With smaller meals given more frequently (230). 

661. Which is the best way to feed an infant — with large 
meals and long intervals between or small meals and short 
intervals between? 

There is no rule that can be applied to all infants. Many 
are ruined and fail to grow, even when partaking of suitable 
food because too much is given at each meal. These infants 
must be fed less at each time and the meals given more fre- 
quently, if necessary. 

662. Will not frequent meals cause indigestion and sicken 
the infant? 

Not 4 if their size is inside the digestive capacity of the 
secretions thrown out at each meal-time. 

663. How often can an infant be fed if this rule be 
observed ? 

There seems to be a large limit to this frequency. Infants 
are often fed every hour during or while recovering from 
sickness, and delicate or damaged infants with limited diges- 
tive secretions must often be fed thus frequently to introduce 



PRACTICAL FEEDING 255 

enough food daily to secure growth or prevent loss of 
weight 

664. Must these infants always be fed in the frequent 
way? 

No; if this is properly done, the digestive power grad- 
ually increases and the meals can be increased by enlarging 
one or two of them a little every few days. In a few weeks, 
usually, they are able to take larger meals less frequently 
(247). 

665. How can a mother know that she is feeding a cor- 
rect proportion of the foods — fat, proteids and sugar? 

The nursing mother knows it by the orange yellow color 
and pasty consistence of the stools, and the hand-fed infant 
shows it by the lemon yellow color and formed consistence 
of them with freedom from mucus, foul odors and much 
gas. 

666. Are these features necessarv for success? 

Yes ; they are. Continued success cannot be obtained 
without them. 

667. Are there any features thai may be present with 
formed stools, which should be avoided? 

Yes ; there must be freedom from excessive gassy dis- 
charges and also putrid or rotten odors (729). 

668. Can these features show with stools that look 
healthy ? 

Yes; for two or three days before an attack of diarrhea, 
but they are always a warning to lessen the food and thus 
avoid sickness. 

669. How does the infant show that it is properly fed? 
By its happiness in daytime and good sleep at night. 

670. When the stools are correct and the infant is cross 
and sleeps poorly, what is wrong? 



256 FEEDING RULES FOR INFANTS 

Generally, it is hungry; but, at times, this crossness and 
poor sleep are due to too rapid increases in the food. In 
this latter condition, gassy and foul stools appear very soon 
(266). The hungry infant will be cross, but the stools will 
be healthy and there will be little or no gassy discharges. 

671. What do green or mixed colored stools show? 
Wrong feeding either in the quality of the food or the 

amount given (706). Mixed colors always show indiges- 
tion in the bowels. 

672. Do these green and mixed colored stools show cor- 
rect form and number? 

No; they are always soft, mucous, watery, lumpy and 
may be numerous also. 

673. What condition, if continued, will guarantee an 
infant's present and future successful growth and develop- 
ment? 

Happiness in daytime, good sleep at night and one or two 
healthy, well-formed stools each twenty-four hours (294). 

674. What is the underlying principle which must always 
be remembered in order to feed infants successfully? 

It is never to forget that the digestive organs will only 
secrete a fixed, amount of digestive fluid for each meal. This 
demands that more food must never be given than this will 
digest perfectly. 

675. If a meal is too large, what will be the result? 

Part of the food will decompose and cause distress (434). 

676. How often will the digestive glands repeat this 
secretion in infants? 

If not overloaded, they will repeat it every hour when the 
diet is one of milk foods, and every one and one-half hours 
when starch is added to the milk. In some very young 



FACTS TO BE REMEMBERED 257 

infants, small milk meals may be repeated more frequently 
than once each hour. 

677. What advantage results from these frequent meals ? 
It enables poorly nourished infants with weak digestive 

organs to partake of a greater amount of food daily than 
they can obtain when taking only a few meals each day 
(428). 

678. Can these frequent meals be made as large as when 
they are few in number? 

The difference in the size of the meals is very little, and in 
many infants, who have been much damaged by improper 
feeding, the frequent meals can be made just as large as the 
fewer ones should be for good results, as damaged digestive 
glands only secrete a small amount at each meal and must be 
used frequently to obtain success. 

679. When is it necessary to feed in this frequent man- 
ner? 

Whenever it is impossible to make the infant happy and 
sleep well on a few meals daily (427). 

680. What is a happy infant — one who sleeps well ? 

One who receives and digests perfectly enough food each 
day to make him grow the average amount needed at his 
age and size and thus continues to sleep perfectly (165). 

681. Can an infant be happy or sleep well when imper- 
fectly nourished? 

Not for any length of time. An infant must receive and 
appropriate enough nourishment to increase in weight suf- 
ficiently or it will be cross in daytime and sleep poorly at 
night (438). 

682. Which is the most successful baby 2 
The happy one. 

Can an infant be successful who is not happy? 

17 



258 . FEEDING RULES FOR INFANTS 

Yes and no. A nursing infant can, but a hand-fed infant 
cannot. 

FACTS TO BE REMEMBERED 

683. Nursing : — 

Few women can nurse an infant successfully for twelve 
months. 

Many fail entirely during the first three months. 

The nursing capacity of all women is reduced at some 
time. 

The time of failure in nursing power varies from a few 
days in some to many months in others (44). 

Gradual reduction in the quantity of milk secreted usually 
means an unfavorable change also in quality (39). 

684. No mother should risk nursing her infant during 
the second summer. This causes expensive sickness and 
most generally is dangerous to the infant's health (44). 

685. A woman whose breasts leak is not usually an 
abundant nurser. 

Women who increase in flesh while nursing are generally 
poor nursers and have cross, thin babies. 

When an infant nurses over ten or fifteen minutes, it is 
proof of deficient milk in the breast. 

Frequent grasping of the nipple and, letting go indicates 
shortage in milk supply (48). 

686. When an infant stops nursing, it has had enough 
and should never be urged to take more. 

Persistent nursing is always dangerous if an infant is 
becoming thin and white with unhealthy stools, especially 
when it causes colic and crossness in daytime with much 
broken sleep at night (36). 

687. Good substitute feeding will not overcome the 
effects of bad nursing when both are continued together. 



FACTS TO BE REMEMBERED 259 

No infant is so hard to feed successfully and make grow 
as the one who has been nursed with unsuitable milk during 
the first few months of its life (37). 

688. When feeding is done with the idea of making the 
infant grow, regardless of the necessity of securing healthy 
stools, it usually results in tedious, severe indigestion and a 
delicate baby (171). 

689. Feeding : — 

The digestive glands of the new-born infant vary greatly 
in their size and foods must be adjusted to their capacity. 
Successful digestion is proven by the healthy character of 
the stools (232). 

690. An infant should not be longer than ten minutes 
in taking a meal, whether nursed or bottle fed (85). 

691. It must be fed regularly in daytime whether asleep 
or awake or within ten minutes after it becomes hungry, 
if the stools are healthy, in order to secure good sleep at 
night (438). It should never be awakened to feed at night. 

692. A healthy infant over six months of age should 
not be fed after the parents retire. A drink of water may 
be given if needed. 

693. Persistent night feeding after an infant is six 
months old always causes a nervous, wakeful, irritable 
child who cannot develop as well as it would on day feeding 
alone. 

694. Night feeding usually means overfeeding or too 
limited day feeding (438). 

695. An overfed infant means a poor sleeper at night 
and a cross one in daytime. 

Overfed children are always subject to vomiting, fever- 
ishness, disturbances of the bowels, much gas, foul odors, 
loss of sleep and very imperfect growth and development, 



260 FEEDING RULES FOR INFANTS 

with correspondingly pale, thin countenances and soft 
flesh. 

Overfeeding is the greatest cause of infantile mortality, 
sickly and puny infants. It always causes an indigestion 
which may continue indefinitely. 

Overfeeding any one of the foods always makes a rest- 
less and unhappy baby. 

Overfeeding cream, skim-milk, sugar or any starch, 
whether home made, or in any proprietary food, damages 
those glands used in digesting it, and if persisted in, ulti- 
mately destroys many of them. This excessive and long- 
continued abuse permanently cripples the infant at the 
digestive point abused (13"). 

696. Every infant is crippled just in proportion as it has 
been overfed. These cripples or wrongly fed children are 
those who d,ie early from slight sicknesses or grow up deli- 
cate and pale to die of tuberculosis, meningitis or Bright's 
disease later in life. 

The successful growth and development of any infant 
depends upon two things : 

1st — The selection of that fat, proteid, sugar or starch 
which it can digest perfectly. 

2d — Upon giving that amount of each food which gives 
healthy stools, free from foul odors. 

A hand-fed infant cannot thrive if it VOMITS. 

A hand-fe<4 infant cannot thrive if it IS HUNGRY 
MORE THAN FIVE OR TEN MINUTES BETWEEN 
MEALS. 

A hand-fed infant cannot thrive if the STOOLS ARE 
LOOSE AND WATERY. 



FACTS TO BE REMEMBERED 261 

697. Infantile Appetite: — 

The appetite of the healthy infant is always correct if the 
food is suited to its digestive power. 

Unsuitable mother's milk creates a false craving for food 
which often results in vomiting or diarrhea when satisfied. 

Any food which irritates the stomach creates a false 
desire for more food in the young infant and nausea in older 
ones. 

Too much cream reduces the appetite; substitution of 
skim-milk increases it (262). 

Constant indifference for food demands a change in the 
proportions of the foods in the meal. 

The overfed infant has a capricious and irregular appe- 
tite (222). 

Varieties in each food change the taste and generally 
stimulate the appetite, giving greater and better digestion. 

698. Poisonous Foods : — 

All foods decompose and become poisonous and irritat- 
ing when not properly digested. Each food in decomposing 
develops products peculiar to itself, but all are injurious and 
many are very poisonous. Animal foods in this condition 
are more poisonous than starchy ones. 

Decomposition of any food, while being digested, always 
allows some poisonous products to enter the blood. These 
are eliminated by the kidneys. 

699. These poisons may cause sickness of any severity 
from headache or slight fever to convulsions ; or from slight 
nausea to the most violent diarrhea. 

700. Continuous poisoning from undigested food, in 
time, may injure the kidneys, causing Bright's disease, or 
may injure some other organ, such as the liver, heart or 
brain with equally serious results (289). 



262 FEEDING RULES FOR INFANTS 

701. Eczema and other skin eruptions are the common 
results of these poisonous digestive products. 

702. Temperatures: — 

The temperature inside the body is higher than our hottest 
summer days. This always causes rapid decomposition of 
food when there is not enough digestive fluid secreted to 
convert it into healthy aliment. Only so much digestive 
fluid is secreted at each meal. When meals are larger than 
this amount of digestive fluid will convert into aliment, 
decomposition must result (674). 

703. Laxatives : — 

All laxatives are irritants and purge because they can- 
not be digested. Most of the foods in infancy act as lax^ 
atives when not perfectly digested (339). No infant can 
thrive well who is given every few days any medicine which 
purges. 

704. Crossness : — 

The happy baby becomes the strong, fat baby. It is 
always the correctly fed one. 

No infant is naturally cross. 

Crossness in a healthy infant is always due to overfeed- 
ing, an unsuitable dietary, hunger or sickness. 

The sickness is often due to some error that the mother 
can correct. 

The cross infant is usually a poor sleeper. 

Crossness is natural and desirable in convalescence from 
sickness (500). 

705. Stools: — 

Human milk makes orange colored, soft, pasty stools. 
They are seldom formed. 

Soft, pasty character in human milk stools results from 



FACTS TO BE REMEMBERED 263 

perfect digestion. If large enough, they guarantee suc- 
cessful growth and development. 

No substitute food can make stools similar to those made 
by human milk. 

Only the yellow stool is healthy from a milk diet. 

Human milk which gives only green stools is poisonous. 

706. Green stools, if continued over a few days, espec- 
ially when slimy, demand immediate weaning to avoid dam- 
aging the infant's digestive power (100). 

A little green without slime is harmless in the yellow 
stool. 

Continuously green, slimy stools without yellow will kill 
any infant, if allowed to continue. This applies to all ages 
but mostly to newly born infants (608). 

Infantile stools usually turn green when exposed to the 
air for a few hours. This is healthy. 

707. Hand-fed infants seldom succeed well when the 
stools do not show some formation (468). 

708. Cow's milk gives one or two soft but formed stools 
daily when successfully fed. They are a light yellow with 
greenish shade. Additions of starch or meat darkens the 
color (232). 

709. Stools from cow's milk or starches are dried out 
in the rectum, giving them form when they remain there 
eighteen to twenty-four hours. 

710. Curds are the only hard lumps ever found in the 
stools of an infant fed on any kind of milk. They are yel- 
lowish white in color and any shape or size, but mostly as 
large as a bean or pea. Usually, there are only two to six 
in a stool, but there may be dozens (392). 

711. Watery and curdy stools are always injurious and 



264 FEEDING RULES FOR INFANTS 

cause sickness, fever and loss of weight. Curds are paused 
by overfeeding of skim-milk. 

712. Pebbly and speckled stools show fair digestion in 
the upper bowel, but an extra secretion of mucus which 
is due to some irritable part of the food (392). 

These pebbles of stool vary in size from a pin-head or 
rice grain upwards. There may be any number from a 
dozen to hundreds of them (393). 

713. Frequent stools are nearly always soft. 

714. One or two soft or watery stools daily will always 
prevent an increase in weight. Usually, they reduce weight. 
They are dangerous in proportion to their number, size 
and fluidity. 

The last part of the stool is always softer than the first 
part and often contains mucus and froth. 

715. Mucus is a natural and healthy secretion of the 
bowel. It is increased by unsuitable food. 

716. Foamy stools show the result of overfeeding. The 
foamy character is due to fermentation. 

717. Food should never be increased when the stools are 
frequent, foul, mucous, splashy or foamy (267). 

718. Food can only be increased when the stools have 
the correct odor, color and formation (267 and 469). 

719. Overfeeding is always followed by extra gas, foul 
odors, frequent mucous or splashy stools. This gas may be 
discharged from mouth or rectum (493 and 263). 

720. Overfeeding of cream causes ropy, greasy, buttery 
or creamy stools with a rancid or foul odor (385). 

721. Overfeeding of ckim-milk causes mucus or curds 
in the stools which may be partly splashy and partly formed, 
or entirely green mucous in character (392). 

722. Overfeeding of sugar causes watery, splashy, 



FACTS TO BE REMEMBERED 265 

gassy stools with redness and scalding in the bowels, 
around the rectum and over the buttocks (409). 

723. Pasty white or clay-colored stools result from over- 
feeding mostly of milk, fat or starch. They are generally 
foul or sour smelling (325). 

724. Dry, crumby stools usually result from over-feeding 
of starch, skim-milk or condensed milk. These stools are 
foul odored and the infant passes much gas. 

725. Foul, rotten-smelling stools of any consistence are 
due to overfeeding animal foods — milk, egg or meat. The 
food decomposes instead of being digested (213). 

726. Urine:— 

Milk-fed infants urinate very frequently. 
Circumcision often lessens the frequency of urination. 
Extremely large, frequent urinating shows too much 
water in the food (289). 

727. Dark, staining urine often indicates overfeeding 
and approaching sickness. 

Dark-colored urine may result from meat juice, bile, 
blood or medicines. 

Very acid urine causes frequent urinating and often 
scalding. 

728. Strong smelling urine shows decomposing food 
products (573). 

Correct feeding reduces the foul odor of the urine. 

729. Gas:— 

Bringing up gas once or twice after each meal is natural 
and correct (487). 

Gas rising frequently between meals is wrong and shows 
fermentation in the stomach. This is always corrected 
by lessening the meals or reducing that food in the meal 
which ferments. 



266 FEEDING RULES FORHNFANTS 

Frequent gassy discharges from the bowels show intes- 
tinal indigestion due to overfeeding or unsuitable food. 

Extra gas in the bowels results from fermentation or 
decomposition and is the common cause of colic (260). 

Rumbling or gassy noises internally are commonly due 
to hunger. When due to indigestion, there will be large 
discharges of gas by the rectum also (489). 

730. Foul odors are due to the decomposition of animal 
foods in the bowels (213). 

Sour discharges of gas and stools are due to fermentation 
of sugars and starches (214). 

The foul-smelling baby is either an overfed one or a 
dirty one. 

731. Vomiting: — 

Vomiting is due to extra quantity of fermentation of food. 

Overfeeding of cream or sugar causes vomiting of food 
one or two hours after meals (259). 

Too much food causes vomiting five to fifteen minutes 
after feeding. 

Changes of position, pressure on the stomach and danc- 
ing the infant often cause vomiting. 

732. Vomiting immediately after meals returns the food 
before it becomes sour. 

Sour vomiting may be natural or due to indigestion 
(333). 

As the digestion progresses, the contents of the stomach 
always become sour. Very sour vomiting is commonly due 
to overfeeding of sugar or starch. Cold water will per- 
petuate vomiting. 

733. Spitting and vomiting of water shows the food is 
too dilute (449). 



FACTS TO BE REMEMBERED 267 

After such an attack, all drinks must be very small and 
always hot also. 

734. All forms of vomiting are corrected by giving the 
stomach a rest (246). 

Rest can be obtained only by lessening the amount which 
enters the stomach. This often demands that nothing be 
given for several hours ; in extreme cases even one or two 
days rest are needed. 

The fear of starving the vomiting infant often prevents 
parents from giving the stomach enough rest to make a 
cure. 

The popular idea is, "Give something to settle the stom- 
ach;" the correct idea is "Give rest to settle the stom- 
ach." The former is generally a failure. The latter is 
always a success. 



CHAPTER X 
DIET FOR SECOND AND THIRD YEARS 

735. How should an infant be fed during the second 
year? 

On the same principle as during the last three months 
of the first year. 

736. Will you explain that principle? 

The young infant develops digestive glands which can 
consume a larger ratio and variety of starchy foods after 
nine months of age than it could when younger. This 
allows these foods to be increased in number and in propor- 
tion as the child demands more food, and the sugar which 
suited the infant's digestive power so well when born must 
be reduced as the starch is increased. In this way, the 
infant during the second year can digest larger amounts 
and more varieties of starch. Eggs and broths may be 
added to or partly substituted for the milk. 

737. What starches are suited to this age? 

All forms of foods made from flour and cereals, and also 
potatoes when properly prepared. 

738. Which way of cooking these best suits this age? 
Boiling. Oat flakes, rice, barley, wheat flakes, farina and 

tapioca present the most suitable forms of these foods when 
boiled (329). Potatoes may be either boiled or baked. As 
they carry so much water, they do not become concentrated 
by baking. 

739. Are baked starches unsuitable for infants of this 
age? 



DIET FOR SECOND AND THIRD YEARS 269 

No; if given moderately, they can be used with advan- 
tage even after nine months (305), except in warm weather. 

740. What forms of baked starches can be given ? 
Bread, crackers, toast, baked potato, soda biscuits, sweet 

cakes in small amounts and breakfast flakes (321). 

741. Why are boiled starches preferable to the baked 
ones? 

Infants at this age have very imperfectly developed 
digestive .glands and are often very greedy. They enjoy 
the taste of the newly baked foods and demand them in 
large quantities. When allowed them by their delighted 
parents, they usually eat enough of these concentrated 
foods to cause indigestion and often more severe sickness. 
If fed in moderation, with the different boiled starches 
which carry so much water, they cannot so easily overload 
their digestive organs. 

742. What is the main difference between baked and 
boiled starches? 

All baked starches are concentrated by drying when 
baked, while all boiled starches are diluted by boiling. 
Otherwise, they are equal in value. 

743. Do the boiled starches ever cause indigestion and 
loose, watery stools at this age? 

Yes ; very commonly mothers fall into the habit of giving 
the foods too dilute and also too much at each meal. The 
result is always the one so frequently made — more food 
given at each meal than there is digestive fluid secreted to 
convert it. This always allows decomposition of part of the 
food ancj frequently loose, foul, rotten stools also. 

744. What must be done to correct this? 

The watery food must be reduced greatly and dry 
starches — bread and crackers — given in place of the boiled 



270 FEEDING RULES FOl. INFANTS 

starches (771). This is especially necessary after seven 
months. 

745. Do these infants thrive better after this change? 
Yes; the loose, foul watery stools disappear and the 

infant quickly improves in spirits, sleeps well and increases 
in flesh when not fed too much dry food. This condition 
is very common as infants become older. 

746. Should milk be increased in amount during the 
second year? 

No; additions of other animal foods, such as eggs, beef 
juice and beef tea, are made at this age to meet the increas- 
ing requirements of the growing child (786 and 788). 

747. Can any fruits or fruit juices be added to this diet 
during the second year? 

Yes; oranges, baked or scraped apple, apple sauce, 
prunes, plums and peaches may all be given in small quan- 
tities if they do not disturb the digestion or show looseness 
of the stools (781). 

748. Are fruits a valuable aid in nourishing a child? 
No; fruits are only relishes like pickles, sauces and jellies, 

and should only be used as such. They are valuable to 
prevent scurvy when all other foods are cooked, and also 
valuable to relieve constipation in some infants, but not 
when fed liberally. They are never nourishing like milk, 
bread, etc. Young children are commonly injured by a lib- 
eral fruit diet, and, in many infants, fruits act like laxatives 
and cannot be given except sparingly. Some infants can- 
not take the smallest amounts without having bowel dis- 
turbance. 

749. How many meals should the infant have daily dur- 
ing the second year ? 

Usually five; but some do well with four. 



DIET FOR SECOND AND THIRD YEARS 271 

750. What should be the standing rule in composing 
these meals? 

Each meal should contain either milk, meat, egg, beef 
juice or broth with some form of starch, cereals, bread, 
cracker, toast, farina, rice or potato during the fall and 
winter. 

751. Is it well to vary the food at the different meals? 
Yes; a new taste gives a fresh impetus or stimulation to 

the digestive secretions, just as the pudding or pie gives a 
new eating desire to the adult after the meat course has 
satisfied his hunger. 

752. How would you prepare milk during the second 
year? 

In the same way as during the last months of the first 
year, only increasing the strength thereof as the infant's 
digestion shows that it is allowable. Some will be able to 
take pure milk at fifteen to eighteen months and others 
must have it diluted. The summer season always demands 
extra caution in this work, pasteurization being an absolute 
necessity during the hot months, with separate bottles for 
each meal of milk and starch food (208). 

753. What would be the proportions and foods for these 
meals ? 

For the first one : Five to six ounces of milk diluted with 
three to four ounces of wheat, barley, rice or oat gruel, a 
small piece of bread and butter or- an equal amount of 
toast. The amount of cream on the milk will be governed 
by the digestive power of the child. All may be sweetened 
slightly and also have a pinch of salt. 

The second meal will be much the same as the first, with 
a little fruit substituted for part of the bread or toast if it 
is well digested. 



272 FEEDING RULES FOR INFANTS 

Third meal : About half of the milk and gruel given at the 
morning meal and the balance made up with four to five 
ounces of chicken, beef or mutton broth some days and a 
poached or soft-boiled egg on the other days with bread, 
crackers or toast as needed. 

754. Should this milk and gruel be given with the bot- 
tle? 

There is no reason for or against the bottle except the 
sanitary one of absolute cleanliness coupled with the labor 
involved. Some infants can be and are weaned from the 
bottle at ten or fifteen months, while others are not weaned 
at two years. When the infant can and will drink food 
from a cup or glass, there is no reason for continuing the 
bottle longer than the first year. 

755. How late should the last meal be given each day ? 
Those with four meals take it at bedtime, 7 to 8 P. M., 

and those with five meals may have it at the parent's bed 
hour, but all meals should be given by 6 P. M. to healthy 
infants. 

756. What is the general principle in changing the food 
of the infant at this age ? 

Lessening the boiled cereals and foods and increasing the 
baked starches with small additions of fruits. 

757. What general rule governs the amounts fed during 
these changes? 

Only those amounts can be given which make the infant 
happy in daytime and sleep well at night. This is always 
found when the stools are one daily, well formed, uniform 
in color and free from bad odors (271). 

758. Can meat be fed to infants during the second year? 
To some, a teaspoonful of scraped chicken, mutton or beef 
may be given, mixed with potato or bread crumbs instead 



SUITABLE PREPARATIONS OF FOODS 273 

of the egg, once a week. This can be repeated more fre- 
quently as the infant grows older (766). 

759. Is water beneficial at this age? 

Yes, especially in summer; but water should not be 
forced on the infant at any time. 

760. When should an infant be forced or coaxed to take 
food or drink? 

Forcing the food or drink is always an error. Healthy 
infants take enough; their error is too often the opposite — 
they take more than they can digest. Coaxing an infant 
to take more is applicable only to those who are convalescing 
from sickness and need more nourishment. Even in these 
cases, harm is frequently done by too much coaxing (591). 

761. How many meals are requisite during the third 
year? 

Generally, four; the night meal being omitted. 

762. How should the foods be changed at this age? 
Milk can be given pure; more solid food used; fruit can 

be given with or before breakfast; butter added to the 
bread and egg given at breakfast time twice each week. 

The second meal is a small lunch and given before the 
midday sleep. It is not as large as the first meal, and may 
contain broth or milk taken with bread or crackers. 

The third meal will contain scraped or finely chopped 
meats, potato, baked, boiled or mashed, rice with vegetables, 
such as fresh peas, beans, asparagus, spinach or celery, all 
well cooked and mashed finely; bread and butter, custard 
or junket twice weekly, and prunes, apple sauce or baked 
apples as dessert on the other days. 

The fourth meal will be a lighter one and composed of 
eight or ten ounces of milk with some form of starch, such 
as arrowroot, barley, farina, bread, cornstarch or toast. 

18 



274 FEEDING RULES FOR INFANTS 

763. Cream — This is a very important food to use or 
avoid, according as it is digested. Most of the infants are 
benefitted by it, but in some cases, it acts as a cathartic or 
emetic, and consequently, is injurious. It can be used as a 
dressing for foods or to enrich skim-milk itself when per- 
fectly digested. 

764. Milk — This is the basis of all foods, but not more 
than a quart should be given daily. When cream is not 
digested, skim-milk must be used instead of whole milk. 
Even this may demand dilution to secure good digestion. 
Some infants have been so damaged by overfeeding with 
milk during the first few months of life that they can digest 
very little of it and water must be substituted as the drink. 

765. Eggs — They must always be fresh and prepared by 
soft boiling or poaching. One daily is enough for a child 
in the third year and the milk should be reduced at that 
meal. 

766. Meat — In some form, tender and properly cooked, 
it should be fed once daily, but not at the same meal with 
egg. The best forms are roast beef or lamb, beefsteak, 
mutton chop and chicken, cut or scraped finely. Fish may 
be fed once each week instead of the meat. Beef and mut- 
ton should always be given rare (787). 

767. Potatoes — These are generally a favorite food with 
children, even during the second year. Some parents are 
foolish enough to feed them during the first year (313). 
Many infants will consume them in large quantities if 
allowed. 

When potatoes are ripe, dry and well cooked, they make 
a very good food,, containing about twenty-five per cent, 
starch ; but they should never be fed to young infants dur- 
ing the summer season, as they frequently cause indigestion 



SUITABLE PREPARATIONS OF FOODS 275 

and diarrhea. This is because the old potatoes are spoiled 
before the warm weather and the new ones are, like green 
fruit, not matured enough to be easily digested. Potatoes 
can be boiled, baked or mashed, but should never be fried 
or scalloped for young children. They can be dressed with 
cream, butter, gravy or beef juice and a little salt. 

768. Vegetables — Of the green vegetables, spinach, 
asparagus, string beans, green peas, squash and stewed 
celery may be used in rotation or one daily. 

769. Cereals — All of these can be used, as they are mostly 
starch. The most important feature is to have them prop- 
erly cooked in order to be easily digested. The list of these 
is very large, as it takes in wheat grits, all breakfast flakes, 
rice, hominy, arrowroot and farina. A few years back, the 
different raw grains were used, but they required three 
hours steady boiling before being fed. At present, all ce- 
reals can be obtained in flake form, previously cooked, and 
require not more than twenty to thirty minutes boiling 
before serving (329). 

Where cereals are used in the form of meal, they cook 
perfectly in twenty minutes quick boiling and are served 
with milk, cream and sugar. 

770. Broths and soups — Meat broths or soups are very 
valuable as an addition to the infantile dietary, but cannot 
be used as substitutes for milk except in one meal each day 
or during a temporary indigestion from overfeeding of 
milk. Meat broths are much more valuable than vegetable 
broths on account of their strength and also on account of 
the pleasant taste and relish they impart to the bread, flour 
and cereals which are made so palatable when added to them. 
Without these additions, broths and soups would have little 
nutritive value. Experience shows that animals fed on them 



276 FEEDING RULES FOR INFANTS 

alone starve rapidly. Beef juice is stronger than the broths 
and can be used more extensively as a substitute for milk. 
The broths make a good diet on which to rest the over- 
worked stomach in many infants. 

. 771. Bread and crackers — These form the staple diet of 
the healthy infant and can be part of every meal in some 
form. They can be used with butter as infants grow older, 
the younger ones having milk or cream as a dressing. 
Toast, stale bread and zwieback are the most desirable 
forms of bread; and gluten, graham and butter or soda 
crackers are most acceptable in the cracker line (790). 

772. Sweet goods should be used very sparingly, as they 
induce a false appetite and craving for excessive amounts 
of these foods and also a distaste for the plainer and more 
reliable dietary (591). 

773. Desserts — Very few desserts are allowable to young 
infants and those allowed must be very simple, easily 
digested ones and given in small amounts. The most reliable 
ones are custard, rice pudding and fruit. Junket may also 
be used when milk is not given at that meal. The nature 
of the infant's dietary does not call for desserts. 

774. Fruits — Different kinds of fruits can be obtained 
at all seasons of the year and small portions thereof can be 
allowed as they come in season. The most marked excep- 
tion to this will apply to those of great acidity or hardness, 
or when they are not thoroughly ripe. The quantity fed 
must always be controlled by proof of perfect digestion and 
the fact that they are only relishes and carry little nutrition. 

FORBIDDEN ARTICLES 

775. Indulgent parents feed almost every food to the 
infant on the ground that they now have teeth, but some 



FOOD FORMULAS 277 

articles should be refused till they are four or five 
years old. 

776. Meats — Pork, ham, sausage, dried and corn beef, 
salt fish, liver, bacon, kidney, meat dressings, duck and goose 
are all difficult to digest. 

777. Bread and cakes-^-Hot bread, rolls and biscuits, 
griddle cakes, much sweet cakes, particularly those with 
fruits or frosted. 

778. Vegetables— Potatoes in all forms during hot 
weather and fried or scalloped at all seasons, cabbage, 
onions, cucumbers, tomatoes, beets, radishes, green corn, 
baked beans and fried egg-plant. 

779. Desserts — Candies, dried canned and preserved 
fruits, nuts, pies, tarts and pastry or much ice cream. 

780. Drinks — Wine, beer, cider, tea and coffee. 

781. Fruits — Stale fruits and those out of season, all 
hard kinds and those that are very sour. 

FOOD FORMULAS 

782. No. 1 — Starch-waters. Starch water can be made 
from cooked oatmeal, rice or wheat flakes, rice or barley 
flour by using two tablespoon fuls of the flakes or one table- 
spoonful of flour to a pint and one-half of water and boil 
one-half to one hour. This should make one pint of the fin- 
ished product, and, enough boiling water should be added, 
if necessary, to make this amount. 

783. No. 2 — Starch jelly. This is made by using double 
the amount of the grain or flour to the same amount of the 
finished product. It is made by boiling in the same way 
and takes about the same time. 

784. No. 3 — Gluten-water. Gluten-water is made from 
any grain, preferably barley or rice, ty boiling four to six 



278 FEEDING RULES FOR INFANTS 

tablespoonfuls of the whole grain in a quart of water. It 
requires one hour's boiling to dissolve the gluten from the 
grain and should measure one pint when finished. The grain 
can be strained out when the boiling is ended. Gluten-water 
also contains a certain amount of starch and is more suit- 
able for delicate stomachs than a pure starch- water, as it is 
more easily digested. Gluten is a vegetable proteid, easily 
digested and very strengthening (315). 

785. No. 4 — Albumen-water. Put the white of one egg 
in one-half glass of water; stir slowly for about five min- 
utes. It must not be whipped, as that makes it frothy. 
Strain through cheese-cloth, sweeten and flavor, if neces- 
sary, to suit the child. 

786. No. 5 — Beef tea. Add one pound of lean, minced 
beef to one pint of luke-warm water. Let stand for one 
hour and then simmer slowly for one hour on the fire. When 
cold,, remove the fat before feeding. Mutton, veal and 
chicken broths are made by using these meats instead of 
beef. 

787. No. 6 — Meat balls or cream. Scrape fine tenderloin 
steak into shreds with a dull knife. Season with salt and 
make into little balls or mix with a little water, making a 
cream thereof for young children. This may be fed warm 
or cold. It will often be retained on a tender stomach when 
other foods are rejected. One or two teaspoon fuls can be 
fed each day to children nearly one year old. Overfeeding 
these foods causes foul, dark stools (.213).- - 

788. No. 7 — Beef juice. This may be made by. the hot or 
cold process. By the hot process, beefsteak is slightly broiled, 
cut into squares and these pieces squeezed in a lemon or 
meat press. By the cold process, the meat is cut up fine 
-and soaked for -three- hours in half -its weight of cold wafer, 



FOOD FORMULAS 279 

then squeezed through a towel, meat or lemon press. More 
than twice the amount of meat juice of the same strength 
is obtained by the cold process. 

789. No. 8 — Junket, curds and whey. These are obtained 
from fresh cow's milk by adding one teaspoonful of liquid 
rennet or sherry wine to half a pint of fresh cow's milk at a 
temperature of one hundred degrees. Stir all well and allow it 
to remain at this temperature one-half hour. The milk 
should then be well whipped with a fork and strained 
through a cheese-cloth. Remove the curds or junket and 
season with salt before feeding. The whey can be fed hot 
or cold and with wine, if necessary. It is a very light food 
and may be used in cases of feeble digestion (395). 
790. No. 9 — Dried bread. Fresh, soft bread is injur- 
ious to the infant with a tender stomach, but as bread is nec- 
essary in feeding children, it should be used in the stale or 
dried form. This is made by cutting it in small slices and 
drying quickly in a hot oven with the door open (771). 

791.' Where toast is required, the drying process may be 
continued still further until the outside of the bread is 
browned. By this process, the yeast germ in the bread is 
entirely destroyed, thus making the starch more digestible. 
If too hard for the little one, it can be soaked in water or 
milk before being fed; but it is preferable to crush it and 
feed in the dry state. Feeding in this way is a slower pro- 
cess, as it demands the saliva in the infant's mouth to soften 
it. In this way, the starch is partly digested in the 
saliva before entering the stomach. This enables the infant 
to consume larger amounts of starch than is possible when 
it is fed in the wet condition. 



INDEX 



PARAGRAPH 

Advice, mother's 30 

neighbor's 24-30,54, 

169, 219, 220 

physician's. .30,48, 62, 175, 176 

Age, weight and food 233 

Albumen, egg 213, 417 

source of 196 

water 785 

Appetite of hand-fed infant. . 

262,620, 697 

nursing infant 85, 697 

hot weather 279 

Arrowroot 310 

Baby, happy 294, 669, 

673,680, 682 

Babies, large 171 

food for 240, 594 

glands of 247 

sleep of 83 

stools of 597 

weight of 287, 475 

Bacteria, souring. . .117, 123, 

145, 146, 209, 565 

Barley 308 

Beef Tea 786 

Bottles, nursing 363-368 

Bread 771, 790 

Breast, sore 64, 72 

nursing 63, 64 

Breasts, suppurating 64, 72 

Breast-pump 66, 78 

Bright's Disease. . . .289, 696, 700 

Broths 770 

Castoria 339 

Castor-oil '. 339 

Catnip 222 

Cellulose 313 

Chart, feeding.. 254, 370-521-522 

record 555 

Charts, filled 584-588 

filling the 220 

Child, hungry 219-223, 256 

Cholera infantum 281, 366 

Cod liver oil 212 

Colic, cause of 36,39, 

55, 81, 86, 90, 93, 150, 260, 
282, 360, 409, 431, 433, 470-474 



PARAGRAPH 

Colic, classes of 472 

evidences of 260 

hunger and 431, 473-474 

medicine and 339 

relief in 152, 260 

stools and 81, 260, 472 

suffering from 81, 150 

three months' 81 

Constipation in a mother. . . 59 

in an infant 96 

laxatives for 339 

Cow, breed of 115 

care of 116 

food for 116 

selecting 114, 115 

Cow's milk 113-117 

Crackers 252, 771 

Cream, age and 240 

age of 611 

amounts of. . .207, 233, 381, 611 

appetite and 262, 620, 697 

constipation and. .243, 379, 383 

digestion of 

...125, 129, 251,300,382, 571 

evaporated 161 

fat in 163 

scurvy and 162 

sterilization and 161 

value of 161 

feeding 243, 613 

fermentation of 384-387 

increasing ... .96, 240, 263, 618. 

overfeeding 

211, 262, 384,387, 720 

pasteurization of 123, 147 

percentage 380, 618 

preparation of 763 

reducing ?62, 263 

removing 213, 300 

stools while feeding. ..... 

243, 385,460,569, 720 

substitute for 212, 300 

suitability of 384 

uses of ..243,379, 621 

vomiting 259, 300, 382, 619 

weight while feeding 383 

Crusts 252 



INDEX 



PARAGRAPH 

Decomposition 281, 675, 698 

Diarrhea, summer 

37 39 88 
93,' 246,' 25^ ' 279-281, 'm, 656 

teething and 342 

Diet, first year 177-185, 646 

mother's 52- 54 

of one food 162, 646 

second year 735 

starchy, a..... 105, 222 

Dietary, change in the 

248, 253, 269 

changing 211, 218 

errors in 93, 166, 210, 

249, 269, 341, 376, 477, 497 

foods in 192, 442 

solid .244,303, 360 

Digestion, changes in. . .276, 440 
imperfect. . . .149, 218, 266, 598 

perfect 232, 265, 689 

power of. .50, 210, 247, 647, 664 

weak 52,188, 251 

Digestive fluid. .33, 35, 87, 225, 
290, 333, 658-660, 674, 676, 702 

Diseases, epidemic 177 

Drinks 142,222,279, 337 

Duty, mother's 169 

parents' 279 

Education, errors in 4 22 

varieties of 7 

where obtained 1- 3 

Egg 725, 765 

Enemas 59 

Eskay's Food 320 

Facts to be remembered. .683-734 

Farina 310 

Fat, digestion of 

124, 163, 129, 300, 308, 562, 620 

fermentation of 386 

overfeeding 619, 723 

removing 213 

source of 193 

. use of 243,379, 621 

Feeding, hand .164-167 

careless . . . « 283 

• day and night. .. .429-437, 692 
errors in.... 210,249, 284 

* failure in 171, 284 

formulas for 293 

imperfect, dangers in. .186-188 
in hot weather. . . .276-280, 593 

length of time for 690 

practical 594-682 

, regular. .438, 648, 651, 653, 691 
rules f or . . 187, 232, 271, 272, 674 



PARAGRAPH 

Feeding, second year 735-774 

slow 589 

stools and 263, 688 

success in 505, 666 

times of 505, 755 

when to commence 164 

Fermentation 150, 281 

Fever 37, 261, 506-508 

Food, additional, to nursing 

95 
age and". '.233,' 285-289^ '568, 613 

amounts of 

233, 243,301,441, 757 

size of baby and. .284, 289, 441 

stomach capacity and 287 

bottle, care of 209 

care of 144, 209, 281-283 

classes of 189 

changes in 247-255, 612 

changing 

...228, 237,248,263,264, 762 

cold 282 

digestion of 

....33, 188,251,301,440, 655 

extra 234,416, 438 

fermentation of 150, 

281, 325, 491, 656, 675, 698, 702 

fever and 261, 506 

forbidden 781 

, formulas 782-791 

for the mother .50- 54 

for different ages 

235-244,610, 613 

glands to digest 33, 290 

hunger and 246, 265, 654 

increases of, checking the 

237, 245 

small 239 

unsuitable 143, 650 

increasing 103, 

142, 220, 231, 246, 248, 255, 
267, 425, 443-446, 612, 614,. 717 

milk .204 

preparation of . . . . 173,. 202-209 

preparing . . . : . ... , : .[. ... 205 

•sickness and •.•-.-.•>. 592 

warm .-:••-.•• '282 

whole day's 648 

Foods, age, weight 233 

elementary, overfeeding. . 211 

Hydrocarbon 190 

Nitrogenous 191 

percentages of 613 

poisonous , .65.7 4 69^-701 

proprietary . .'319-323, ' 540, *645 



INDEX 



PARAGRAPH 

Foods, reducing 

228, 249, 253, 262, 266, 279, 650 

removing 213, 250 

soft 590 

sources of 193-197 

starchy 252 

substitution of .. .210-218, 253 

sweet 591, 772 

weight and 102, 

233, 234, 245, 255, 272, 650 

Fruits 591, 774 

Gas... 150, 238, 255,260,306, 

...487-496, 515, 729, 730 

Glands, digestive,damaged. . 

35,88, 

91, 93, 100, 105, 166, 188, 
211, 218, 225, 251, 428, 572, 606 
foods and. . . .186, 290, 301, 689 
growth of the.... 165, 247, 

272, 303 

power of the... 35, 87, 187, 
...210, 251,386,432,436, 647 

secreting 33, 290, 676 

size of the .. . 689 

strengthening the 187 

Gluten 252, 315-318, 784 

Gruel 56, 603, 753 

Habits, careless : 283 

children of 1- 5 

Hand-feeding 164-167 

evidences in 220 

. experienced in 175, 176 

failing in 171, 284 

ignorance in 174-176 

improper 188 

infants requiring 164 

mothers doing... 168, 169, 

173, 186, 220, 221 

nursing and 99-105 

one person. . .167, 173, 176, 203 

proper 167 

success in 170, 172, 

230,271, 273 

Hiccup or -Hiccough 343 

.Horlick's Malted Milk 320 . 

Hunger * .' . . .-.48, 

' 219-223; 226, 228; 256, 

. . 265, 345, 501-503, 652, 654, 670 " 

Imperial Granum.'. . ;. .",. 320 

Indigestion of infants 86, 

93, 144, 213, 229, 246, 279, 
282, 360, 398, 434, 504, 662, 695 

of mother.. 42,49,52, 56 

Infantile mortality rate 185 

Infants, qpjicky 472 



PARAGRAPH 

Infants.condition of, 219, 223, 337 

cries of 220, 221, 344-3<m 

cross 

36, 41, 49, 83, 90, 93, 99, 
152, 228, 238, 500, 670, 704 

damaged, feeding 

, 103,167, 

225, 268-275, 572, 652, 687 

stools of 8!) 

weight of 91, 92, 268 

drooling of 171,302, 580 

fruit for 747 

growth of 165, 

230, 247, 273, 301, 636, 696 

hand-fed, classes of 106 

digestive power 

165, 188, 210, 276, 280 

feeding .167, 661,681, 688 

according to stools 

263, 688 

articles requisite for.... 205 

rules for 

187, 232,237,271, 272 

fever in 261, 507 

food for 189,293,610, 613 

preparing 202-209 

growth of 165, 673 

overfed, craving of 222 

overfeeding 

...143, 211-214, 221,223, 
343, 409, 504, 514, 675, 695, 719 

stools of 228,. 263, 459, 707 

vomiting of 450, 649, 656 

weight of 476 

when to feed 164 

healthy •. . . 294 

laxatives for. 339, 703 

nursing, additional food 

for 87-98 

classes of 79 

digestive power of 

...35,50, 87 

feeding, according to 

stools : 89 

regular, of . . : .84 

. . imperfectly fed: . .82;S7i: ;91 
overfeeding %•• • • • • • • ■ ■ \ * "86 

• sleep of-.*.-. -.-....'• 83 

stools of "...48, -80, 

' ' 81/ 89,' 98, 100, 104, 458, 

597, 601, 604, 608, 707-725 

vomiting of 86, 649 

weaning of 83, 106 

weight of.. 91, 475, 606 

urging to eat. ....... . .591, 760 



INDEX 



PARAGRAPH 

Judgment, mother's, a. . . 186, 219 

Junket 789 

Laxatives, colic and 57, 339 

constipation and 339 

for infants 339, 703 

mothers 57 

Lime-water 208, 222, 398-401 

Meals, bottling the 208 

day 429 

extra 43, 416, 455 

fever and 261, 506 

food in the 207, 750-753 

frequency of 224-230, 

419, 427, 428, 660-664, 677-679 

hunger before 

226-228,501-505, 570 

increasing the. . . .238, 255, 289 

intervals between 

228, 427, 441 

large 224, 289, 433, 675 

night 43,437,692-694 

number of . . . .424, 429, 454, 749 

reducing the 225, 428, 658 

regular 223, 438 

size of the 229,230, 

289, 422, 429, 437, 505, 678 

sleep and 429,437, 438 

small 223,229, 660 

table of 441 

warm. 282 

warming over a 223 

weight and 255 

Measures 205 

Meat, juices, addition of 162 

decomposing 281 

overfeeding 213, 725, 787 

stools from ...263, 787 

substitution of 213, 417 

Medicine, classes of 57 

colic and 339 

constipation and 339 

for infants 339, 456, 498 

for mothers 49, 57- 62 

sleep and 498 

Mellin's Food 320 

Milk, age and 241, 391 

age of 111,207,299, 567 

amounts of 

....95, 137,231,233,243, 391 

analyses of 130 

bacteria in 117, 123, 146 

caring for 

...117, 122,144,281,559, 564 
changes in. . 148 



PAHATR aptt 

Milk, condensed brands 160 

overfeeding 724 

selecting 160 

starch and 159 

substitution of 159 

sugar in 158 

teething and 158 

value of 157-159 

cooling 118, 122, 559 

constipation and.. 96, 390, 560 

cow's 113-117 

cream and 129, 561, 563 

" in.... 128-130, 380, 566 

digestion of . ; 

151, 231,251,394, 611 

drinking 140-143 

mothers 55, 56 

feeding 95, 292, 568 

foods in... 

....34, 290,292,627,628, 647 

fresh '. 

...108, 111, 204, 207, 299, 567 

frozen Ill 

handling, methods of 

117,122, 125 

herd 107, 111 

human, addition of 201 

age of 200 

benefits of 198, 199 

borrowing 199, 201 

change in 40 

colic and. 471 

composition of 33 

digestion of 35 

foods in 34 

injurious 35- 40 

insufficient. . . .48, 85, 92, 99 
irritating but good. . .41- 43 

overfeeding 86 

physician's view of. ... . 32 

poor... 49 

stools produced by 

36, 80,81,89,100, 705 

substitution of, 198, 270, 275 

substitute for 94, 291 

suitability of 31, 35, 200 

impurities in 109, 149 

increasing 

...231, 391,612,622,627, 746 

measuring 205 

overfeeding .392, 721 

pancreatizing 150-156 

pasteurization of. 

dl6, 144-147, 281, 565 



INDEX 



PARAGRAPH 

Milk, peptonization of 

43, 150-156, 275 

predigestion of 150-156 

preparing 95, 752 

proteids in 150, 196, 389 

quality of 110, 112, 113 

removing 213 

rennetizing 395, 150-156 

selecting . 107-112 

separation of cream 

118-126,558, 563 

skim 389 

solids in 134 

souring of 144, 204, 281 

sterilization of 

123, 144, 148, 149 

stools produced by 

232 263 
39i^94,' 461, '569,625,708! 721 

strength of 132 

substitute for 96, 213, 417 

substitution of 291, 300 

sugar in 144,403, 406 

temperatures 118-126, 128 

top 299, 562 

twelve-per-cent 297-299 

uses of 231,243, 389 

water in . . 136 

weight and 231 

whole 129, 296 

Milking, precautions in 117 

Milks, difference in, 130, 132, 138 

Mortality rate 185 

Mothers, American 21 

nursing, abused 24- 30 

advices to 24- 29 

ambition of 21 

capacity of 44, 683 

classes of — 45 

constipation in 59 

duty of 46, 98 

food for...... 50-53, 54, 602 

giving advice 26, 30 

medicine for 49, 57- 62 

milk for.... 55,56, 602 

" secretion of 164 

changes in the. .39, 40, 683 
good, essentials384,2 
49, 54, 56, 81, 200, 600-604 

insufficient 48, 

85, 92, 99, 595, 596, 685 

poor 37,49, 164 

sickness of 60- 62 

responsibility of 20- 23 

Mouth, sore 358, 592 



PARAGRAPH 

Mouthwash 356-358 

Nestle's Food 320, 323 

Nipples 359-362 

human, short 6Q 

sore, cause of 65, 67- 70 

clothes and 73 

disinfecting 72 

mothers with 71 

remedy for ... . 66, 68, 71, 75 

shields for 74, 77 

treating 71- 76 

Nipple, shield 77 

Nitrogenous foods 191 

Nurse, qualities of a 173 

reliable 174 

wet 47 

Nursing, errors in 35, 36 

feeding and 87- 98 

frequent 68, 75 

how long. . . .609, 636, 683, 684 

imperfect 98-105, 687 

importance of 46, 76, 98 

length of time for. .42, 85, 690 
persistent. .36, 87, 606, 686, 687 

positions in 75 

regularity in... 83, 84,438, 649 

rule for 438 

sleep and 84 

successful 665 

Nutrition, improper 

15, 93, 98, 521, 667, 668 

perfect, habits regarding, 1- 5 

how to obtain 6 

evidences of. .520, 669, 673, 680 

ignorance of 20, 174 

nation's 16 

proof of our 184 

neglect of 9- 12 

physicians' view of 8, 179 

position, regarding 178 

teaching f utu re 7-17, 22 

Oats, fat in 193, 307 

Overfeeding, results of 

143, 211-214, 

223, 343, 409, 514, 675, 695, 719 

Over-nursing 86 

Pain 260, 347 

Pasteurization 145-147 

Pepsin 43 

Peptonization 150-156 

Potatoes 313,314, 767 

Proprietary foods 319-323 

Proteids, increasing the. .. . 622 
milk, substitute for. . .213, 417 
overfeeding the . .213, 599, 625 



INDEX 



PARAGRAPH 

Proteids, removing the .... 213 

source of 196, 624 

use of 623 

vegetable, 197, 213, 315, 417, 725 

Rennet 150 

Robinson's barley flour and 

groats 321 

Saliva, secretion of 

302, 360, 580, 676 

Salt 312 

Salts, mineral 192, 635 

Schedules, feeding 573-579 

foods in the 301 

milk in the 558, 560, 561 

Scurvy 162 

Sickness, evidences of 510 

foods in.... 592 

Sleep 36,81,84,90, 

150, 238, 348, 438, 440, 497, 670 

Spitting 258, 444-450, 733 

Starch, arrowroot 310 

injury produced by 217 

substitution of .. .215, 217, 253 

sugar and 

....248 263, 306,414,629-632 

sugar in 306, 327 

suitability of, 324,325,645, 737 

wheat 304,307,319, 637 

Starches, adult 302 

amounts of 329, 414 

baked. . .304, 320, 321, 644, 739 

barley 304,307, 637 

boiled 304,305,642, 741 

changing j 217 

color of 316 

constipation and.. 304, 307, 312 

cooking 305, 329, 738 

corn 193, 307 

digestion of 

216, 247, 249, 252, 302, 580, 637 

dry 252, 415, 581, 583, 744 

effects of 307 

farina 310 

-fat in 193,307, 637 

feeding 

104, 105, 216, 248, 252, 303, 
307-311, 414, 581, 634, 636, 646 

errors in 217, 326 

flake 305 

forms of 307, 329 

gas and 494 

gluten 315-318 

increasing 263, 304, 330 

liquid 252, 323 

malted 320, 327, 643 



PARAGRAPH 

Starches, milk in,condensed, 323 

mixing 309, 320, 332 

oat 193, 304,307, 637 

overfeeding 325, 723 

potato 195, 313 

preparing 304, 639, 769 

proprietary 319-323, 641 

composition of 322 

digestion of 320 

making, process of. .320, 641 

suitable 645 

wheat in 319-322, 331 

pure 307, 316 

raw 326, 638 

rice 304,307, 637 

salt and.. 312 

schedules containing. .573-579 

selecting 308, 324-328, 331 

source of 195, 316 

stools from . . . 325, 462, 709, 723 

strength of 311 

table of 329 

tapioca 310 

use of 195, 629 

Starch- water, strength of . . . 

304, 414, 782 

Statistics 178-185, 277 

Sterilization . ..123, 144, 148, 149 

Stomach, acid in 386 

capacity of Ihe. . . .224, 286-289 

weight of infant and, 284-289 

rest for the, 222, 246,432,435, 734 

sick 255 

sour 333-335 

Stools, brown 89, 263, 708 

changing food according 

to 263, 658 

curdy 

81, 263, 392, 393, 626, 710, 721 

dry 263, 7z4 

foul. 36,100, 

213, 228, 238, 250, 255, 263, 
266, 326, 385, 464, 720, 723, 725 

foamy 267, 716 

'frequent .41, 228, 713 

gassy 36, 

86, 263, 266, 267, 326, 722, 724 

granules of 393 

greasy 263, 720 

green 41, 48, 

55, 86, 89, 100, 150, 260, 
263, 597, 608, 671, 672, 706 

mucous 35, 41, 48, 

55, 57, 89, 150, 213, 250, 
260, 263, 597, 608, 715, 721 



INDEX 



VI 1 



PARAGRAPH 

Stools, number of . . .80, 102, 228 

orange colored 81, 705 

pasty 80,705, 723 

pebbly 712 

ropy 263, 720 

slimy e 

..35, 36,89, 100, 208, 267, 706 

soft 228, 

238, 250, 260, 263, 467, 705, 708 

watery...' 89,208,250, 

. .267, 306, 326, 711, 714, 722 

white or light gray 723 

yellow 

.41,80, 86,89,263, 705 

Sugar, addition of , . 236 

amounts of 

....97, 233,243,407,408 ,616 

as the basis of food 

97, 242, 403 

avoidance of 404 

cane, amount of 233, 236 

strength of 408 

substitution of 215,408 

suitability of 405 

digestion of 215,251, 410 

feeding 406 

fermentation of 409 

increasing 242, 408, 616 

measuring 206 

milk and, human 403 

milk, amounts of 233 

feeding 407 

fermentation of 408 

grades of 413 

increasing 236 

overfeeding 214, 617 

pasteurization of 147 

percentages of 403 

reducing... 214, 248, 263, 306 

strength of 407, 408 

substitute for 215, 411 

suitability of 405 

overfeeding. .409, 617, 633, 722 

pasteurization of 147 

percentages of 413 

reducing. .97, 263, 412, 631-633 

solution of 125, 

207, 236, 242, 402, 407, 408 

straining the 413 

Source of 194 

starch and. . .248, 306, 412, 629 

stools while feeding 

214,409, 722 

strength of 236, 407, 408 

substitute for 215, 411 



PARACKAIII 

Sugar, suitability of 405 

uses of 403, 62] 

Tapioca 3J»> 

Teething, diarrhoea and. . . . 342 
disturbances of digestion 

and 171, 340-342, 278 

Temper 352-355, 499 

Temperature, infant's 

261, 506, 512, 702 

of food 281 

milk 118-126 

Thermometer 50y-512 

Thirst 279, 346 

Toast 252, 791 

Top-milk 289, 299 

Urination. .289, 336, 338, 726-728 
Urine, circumcision and. .. . 726 

color of 727 

odor of 513, 728 

Vegetables 768 

Vomiting, nursing infants. . 

; 37, 86, 366, 453, 649 

hand-fed infants 

...253, 257-259, 333-335, 
434, 450-453, 656, 731-734 

Water, amount of 233 

fever and 261, 337 

in hot weather 

141, 279, 337, 759 

measuring 205 

overfeeding 289, 336, 733 

sweetened 338 

Weaning 31, 38, 

60, 64, 83, 92, 100, 106, 605, 609 

Weather, cool 276-278 

Weighing, necessity for. . . . 478 
regular. .244, 272, 478, 486, 605 

scales for 481-486 

Weight, age and 244, 475 

age, food and 233 

average, at birth 287, 475 

cream and . . . 102, 233, 234, 
244, 255, 272, 274, 383, 614 

hunger and 

. . . 226, 227, 255, 501-503, 654 

increasing in 244 

losing 36,93, 103, 

106, 228, 274, 479, 480, 503 

progress in, erratic 479 

stationary . . . .48, 227, 246, 480 
stomach capacity and. . . . 286 

summer 277 

Wet-nurse 47 

Whey. 395-397, 789 

substitution of 96 



EDUCATIONAL 
FEEDING CHARTS 

By CHARLES DOUGLAS, M. D. 

Professor of Children's Diseases and Clinical Medicine, 
Detroit College of Medicine; Consulting Physician to 
Harper Hospital; Senior Physician to the Prot- 
estant Orphan Asylum; Member of the 
Ohio State Pediatric Society, 
American Medical Associa- 
tion and Michigan 
State Medical 
Society 

These charts are made to assist mothers in feeding their infants and 
are duplicates of the charts described in this book, "Feeding Rules for 
Healthy Children." When properly and regularly rilled, these charts are 
a dietetic education to any mother, and enable her to protect her children 
against two-thirds of all the sicknesses from which infants and children 
suffer during the first three years of their lives. They are an invaluable 
direction on dietary during health and sickness. 



Price, 25c per dozen 
BABY BOOK COMPANY 

Publishers 
DETROIT, MICH. 



Feeding Rules for Delicate Infants 

(Now being prepared) 

By CHARLES DOUGLAS, M. D. 



BABY BOOK COMPANY 

Detroit, Mich. 






How to Raise Healthy 
Children 



A BOOK OF SIX HUNDRED AND THIRTY PAGES. ENTITLED 

FEEDING AND NURSING THE BABY 

By CHARLES DOUGLAS, M. D. 

Professor of Children's Diseases and Clinical Medicine, 
Detroit College of Medicine, Consulting Physician to 
Harper Hospital, Senior Physician to the Protestant 
Orphan Asylum, Member of the Ohio State 
Pediatric Society, American Medical Asso- 
ciation and Michigan State 
Medical Society. 



This book is a complete treatise on all things pertaining to infants and 
children, both in health and sickness. It contains eighteen chapters treat- 
ing the following subjects: The Pregnant Woman; The Mother; Human 
Milk; Cow's Milk; The Elements in Milk and Preparation of Milk Foods; 
Foods; Feeding; Development of the Baby; Care of the Baby; Facts Con- 
cerning the Baby; Home Treatment of Sick Children; Symptoms and their 
Values; Accidents and Emergencies; Infectious Diseases; Digestive Dis- 
turbances; Skin Diseases and Deformities; General Diseases and Derange- 
ments; One Hundred and Twenty-three Formulas of Foods and Remedies. 

With Fifty-five Illustrations, Twenty Halftones 
and Four Colored Plates 



PRICE $2.00 



BABY BOOK COMPANY 

Publishers 
DETROIT, MICH. 



I 



